Effectiveness of cervical encerclage and its perinatal outcome-A cohort study

Authors : Indu M Madhu, Anoj Kattukaran, Susan Thomas

DOI : 10.18231/j.ijogr.2022.051

Volume : 9

Issue : 2

Year : 2022

Page No : 267-279

Introduction: Cervical incompetence is the inability of cervix to support a full term pregnancy. The patient presents with a partially dilated cervix, with or without a history of recurrent mid trimester losses or preterm births. It is believed thatthe forced mechanical closure of an ‘incompetent’ cervix with a suture maintains the cervical length, thus preventing preterm labor.
Objectives: To evaluate effectiveness of cervical encerclage in women with cervical incompetence and its perinatal outcomes.
Materials and Methods: This ambispective cohort study was conducted in the department of Obstetrics and Gynecology, Amala Institute of Medical Sciences, Thrissur. Medical records were reviewed during the period of 2008-201. 79 cases were included in this study.
Clinical data, gestational age, cervical dilatation at the time of cerclage, cerclage-delivery interval, gestational age at the time of delivery, birth weight and maternal complications, were collected.
Results: Mean gestational age at the time of cerclage is 18.686 ±4.0200 weeks. Mean cerclage - delivery interval is18.510 ±6.3026 weeks. Cerclage delivery interval in prophylactic cases is 20.13 ±3.79 weeks and in rescue cerclages it is 9.487± 2.73 weeks. Prophylactic cerclage is more effective than rescue cerclages (p=0.0002). Mean gestational age at delivery is 36.666 ±5.3354 weeks. 23cases (29%) had low birth weight babies (<2500> Conclusion: Based on this study we conclude that cerclage is beneficial in prolonging pregnancy with a consequent reduction of fetal losses and neonatal deaths.
 

Keywords: Cervical encerclage, Cervical insufficiency.


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