Cervical cerclage with history-based Indication in cervical Insufficiency: five-year experience in Etlik Maternity Hospital

Objective: Although history-based indication (prophylactic cerclage) is controversial in the literature, it has been still used widely. Our purpose in this study was to review cervical cerclage cases with historybased indication carried out in our Perinatology Department. Methods: Those with history-based indication among the cases who had cervical cerclage in our department between January 2007 and May 2013 were analyzed retrospectively. Among 196 cases who undergone cervical cerclage, 156 cases were included to our study who had complete records and gave birth at our hospital. Results: Mean cerclage practice and weeks of delivery were 13.9±1.7 and 34.7±6.8, respectively. The mean period elapsed from cerclage to delivery was found as 20.7±6.7. In the first week after the procedure, preterm premature rupture of membranes (PPROM) was observed in four (2.5%) cases. Preterm premature rupture of membranes occurred in the late period in 8 (5.1%) cases (mean week of gestation was 31.1±0.1). Preterm labor was observed in 46 (35.9%) cases. Mean birth weight was 2919±803 gram. Early neonatal death was observed in 8 (5.1%) cases, and all these babies were born before 24 weeks of gestation. Conclusion: Prophylactic cervical cerclage based on history may be useful in patients who have spontaneous second trimester loss. However, complications such as PPROM and bleeding should be paid attention after the procedure, and high risk of preterm labor should be taken into consideration. Randomized studies are required to find out how many losses there should be in previous pregnancies in order to practice cerclage.