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Emergency cerclage: a review

J M Aarts¹, J T Brons, H W Bruinse

¹Department of Obstetrics and Gynaecology, Utrecht University Hospital, The Netherlands.

Obstetrical & Gynecological Survey

|June 1, 1995

Summary

Emergency cervical cerclage can save pregnancies in cases of cervical incompetence, but carries a high risk of infection and complications. Further research is needed to improve outcomes and prevent chorioamnionitis.

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Area of Science:

Obstetrics and Gynecology
Maternal-Fetal Medicine

Background:

Cervical incompetence with advanced cervical changes in the second trimester presents significant obstetric challenges.
Cerclage operation is often considered the primary intervention to prolong gestation until fetal viability.

Purpose of the Study:

To evaluate the efficacy and complications of emergency cervical cerclage in patients with advanced cervical changes in the second trimester.
To review and compare findings with existing literature on emergency cerclage procedures.

Main Methods:

A retrospective study of 20 patients undergoing emergency cervical cerclage.
A review of comparable studies published between 1980 and 1992.

Main Results:

Emergency cerclage successfully prolonged gestation in the majority of cases.
High incidence of complications, particularly infectious complications like chorioamnionitis, was observed.
Many patients required prolonged hospitalization or bed rest, with few pregnancies reaching full term.

Conclusions:

Emergency cervical cerclage can be beneficial in prolonging pregnancy for cervical incompetence.
Preventing infectious complications, especially chorioamnionitis, is crucial for improving procedural outcomes.
Future efforts should focus on strategies to mitigate infection risks associated with emergency cerclage.

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