Elektif ve Acil Serklaj Uygulamalarının Perinatal Sonuçlar Açısından Analizi

Aim: We aimed to examine the elective and emergency cervical cerclage results performed in our referral tertiary care center and evaluate their effectiveness. Materials and Methods: The results of 56 patients who underwent cervical cerclage with the diagnosis of cervical insufficiency in Bursa Yuksek Ihtisas Training and Research Hospital between January 2016 and January 2020 were retrospectively analyzed. Patients who underwent Mc-Donald type transvaginal cerclage were included in the study. Patients with multiple pregnancies, abdominal cerclage, and deliver results that could not be reached were excluded from the study. According to the cerclage indication, patients were examined in two groups as elective cerclage (with history indication) and emergency cerclage (with physical examination and ultrasonography indication). Results: The gestational week when cerclage was performed was determined as 20.8 ± 0.7 and 13.9 ± 0.1 weeks for elective and emergency groups, respectively. In the elective cerclage group, the time between cerclage procedure and delivery and the week of delivery was significantly higher (151.1 ± 6.5 days / 35.2 ± 0.9 weeks vs. 23.7 ± 18.5 days / 26.6 ± 1.4 weeks). In relation to this, birth weight was significantly higher in the elective cerclage group than in the emergency cerclage group (2913.7 ± 129 gr vs. 1611.4 ± 232.2 g). Neonatal intensive care requirement was less in the elective cerclage group. There was no statistically significant difference between the two groups in terms of delivery method and abortion rate. Conclusion: Emergency cerclage performed in patients presenting with painless cervical aperture or having a prominent short cervix on ultrasonography effectively prolongs gestational period and reduces poor perinatal outcomes, although not as much as elective cerclage. There is a need for prospective studies to determine the efficacy of emergency cerclage compared to elective cerclage, in which patients with emergency cerclage are better randomized and with a larger number of patients.