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Favorable outcome following emergency second trimester cerclage
Author(s) -
Debby A.,
Sadan O.,
Glezerman M.,
Golan A.
Publication year - 2007
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2006.09.002
Subject(s) - medicine , cervical dilation , cervix , chorioamnionitis , cervical cerclage , gestational age , cervical insufficiency , retrospective cohort study , vagina , pregnancy , premature rupture of membranes , obstetrics , gestation , gynecology , surgery , genetics , cancer , biology
Abstract Background: To evaluate the outcome of midtrimester emergency cerclage with or without bulging of membranes. Methods A retrospective cohort study of 99 women who underwent emergency second trimester cerclage (16–27 gestational weeks). In 75 women the cervix was dilated and effaced but without bulging of membranes (group 1), and in 24 women the dilation and effacement of the cervix were accompanied by bulging of membranes into the vagina in an hourglass formation (group 2). McDonald technique was applied in all patients. Results Prolongation of pregnancy was significantly longer in group 1 compared to group 2 (14.3 ± 6.5 vs 9.3 ± 4.8 weeks, p = 0.007). The mean gestational age at delivery was significantly higher in group 1 compared to group 2 (34.6 ± 4.6 vs 29.5 ± 3.2 weeks, p = 0.001). The incidence of chorioamnionitis was higher in group 2 compared to group 1 but statistically insignificant (25% vs 15%, p = 0.2). The overall neonatal survival was 83% (82 out of 99 neonates), without statistical difference between the two groups (86% in group 1 and 71% in group 2, p = 0.2). Conclusions Favorable neonatal outcome may be accomplished in patients with cervical incompetence in the second trimester of pregnancy following cervical emergency suturing even performed when the membranes are bulging through the cervix into the vagina.