Cervical incompetence: the use of selective and emergency cerclage
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Ratko Matijevic
Abstract
Objective: This prospective case series was performed in order to assess pregnancy outcome of women with tentative diagnosis of cervical incompetence undergoing selective and emergency cervical cerclage.
Methods: Women recruited in this case series were divided into two groups. The selective group (n = 13) was chosen among pregnant women with a history suggestive of cervical incompetence, but no clinical evidence of threatened miscarriage. The definition of cervical incompetence was dilatation of internal cervical os with shortening of the cervix less than 25 mm and “funnelling” of 25% and more, found on the ultrasound examination of the cervix. The emergency group (n = 12) had clinical symptoms of threatened miscarriage. After exclusion of infection and in the absence of uterine activity they were counseled and offered cerclage.
Results: After cervical cerclage all women were treated in the same way as per our clinical protocol and monitored until delivery. The median gestational age at delivery was 36 weeks (19–39) in the selective group and 33 weeks (22–38) in the emergency group. This difference is not statistically significant. There was 1 miscarriage (8%), 5 pre-term deliveries (38%) and 7 term deliveries (54%) in the selective group; and 4 miscarriages (33%), 3 pre-term deliveries (25%) and 5 term deliveries (42%) in the emergency group. Total neonatal survival was 19/20 (95%) if pregnancy exceeded 24 weeks, making perinatal mortality 5%. There was no differences between selective and emergency groups (1 of 12 in selective vs. 0 of 8 in emergency).
Conclusion: Overall, it can be concluded that both selective and emergency cerclage may have some benefits in patients with cervical incompetence. However, in the absence of a randomized-controlled study, these beneficial effects described cannot be considered as proved.
Copyright © 2001 by Walter de Gruyter GmbH & Co. KG
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Articles in the same Issue
- Fetal pulse oximetry: current issues
- Ketanserin for the treatment of preeclampsia
- 11β-hydroxysteroid dehydrogenase (11β-HSD-II) activity in human placenta: Its relationship to placental weight and birth weight and its possible role in hypertension
- Cervical incompetence: the use of selective and emergency cerclage
- Detection of cervical immunoglobulin A in normal pregnancy
- 24 hour-CTG monitoring: comparison of normal pregnancies and pregnancies with placenta insufficiency
- Chlamydia trachomatis infection and the risk of perinatal mortality in Hungary
- Respiratory distress in heavier versus lighter twins
- Superior mesenteric artery blood flow velocity in small for gestational age infants of very low birth weight during the early neonatal period
- Longitudinal observation of deterioration of Doppler parameters, computerized cardiotocogram and clinical course in a fetus with growth restriction
- First-trimester ultrasonographic investigation of cardiovascular anatomy in thoracoabdominally conjoined twins
- Low taurine, gamma-aminobutyric acid and carnosine levels in plasma of diabetic pregnant rats: consequences for the offspring
- Spastic diplegia is not associated with intrapartum hypoxia
