Premium
Emergency cerclage versus expectant management for prolapsed fetal membranes: A retrospective, comparative study
Author(s) -
Aoki Shigeru,
Ohnuma Emi,
Kurasawa Kentaro,
Okuda Mika,
Takahashi Tsuneo,
Hirahara Fumiki
Publication year - 2014
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12207
Subject(s) - medicine , expectant management , retrospective cohort study , obstetrics , fetus , pregnancy , surgery , gestation , genetics , biology
Aim To compare outcomes after emergency cerclage versus expectant management for prolapsed fetal membranes in women with cervical incompetency. Methods The J anuary 2000– D ecember 2012 hospital database was analyzed to identify women managed for prolapsed fetal membranes who did not have premature rupture of membranes, clinically discernible chorioamnionitis, or treatment‐resistant uterine contractions from 15 to 26 weeks of gestation retrospectively. Durations of pregnancy prolongation and numbers of deliveries after 32 and 28 weeks were compared between women undergoing emergency cervical cerclage and those receiving expectant management. Results Fifteen of the 35 women underwent emergency cervical cerclage (‘cerclage group’), while the other 20 were managed expectantly (‘bedrest group’). In the cerclage group, median gestational ages at procedure and delivery times were 22.6 (15.9–26.1) and 32.4 (19.4–41.6) weeks, respectively. Median gestational ages on admission and at delivery in the bedrest group were 23.4 (21.1–26.4) and 26.0 (23.1–36.4) weeks, respectively. The median duration of pregnancy prolongation was 44 days (4–165) in the cerclage group and 12.5 days (2–93) in the bedrest group ( P < 0.01). Numbers of deliveries after 28 and 32 weeks were both significantly higher in the cerclage than in the bedrest group ( P < 0.05). Conclusion In women with prolapsed fetal membranes but no signs of infection or painful uterine contractions, emergency cervical cerclage prolonged pregnancy duration as compared with expectant management.