Evaluation the effect of emergency cervical cerclage on treatment of cervical incompetence——clinical analysis of 20 cases

Objective:To analyze the curative effect of cervical cerclage on cervical incompetence.Method:A total of 20women with cervical incompetence(CI) were enrolled in this study from June 2005to December 2009.Patients with CI were treated with preventive cervical cerclage,emergent cervical cerclage,or non-cervical cerclage treatment.After admission,patients were arranged to fulfill relating examinations.Preventive and emergent groups accepted cervical cerclage operation,while conservative group accepted tocolytics therapy.Patients were discharged if there were no signs of abortion 5to 7days after treatment.After discharge,patients should do prenatal examination regularly,and they were followed up until termination of pregnancy.Outcomes observed were as follows:(1) prolongation of pregnancy in weeks after cervical cerclage or conservative management,(2) birth weight of newborns(BW),(3) presence of survival newborns,(4) presence of giving birth after the 34th week,(5) presence of fullterm labor,(6) presence of premature of membranes.Statistical analysis was done with the observed data.Both groups received multifactorial treatment with bed rest,tocolytic agents,broad-spectrum antibiotics.Result:(1) Prolongation of pregnancy:preventive cervical cerclage:154.86±10.51d,emergent cervical cerclage:34.86±46.84d,non-cervical cerclage:94.75±30.93d.(2) BW:preventive cervical cerclage:3 171.43±424.12g,emergent cervical cerclage:1 557.14±907.11g,non-cervical cerclage:2 812.50±383.79g.(3) Neonatal survival:preventive cervical cerclage:7cases,emergent cervical cerclage:2cases,non-cervical cerclage:6cases.(4) Presence of giving birth after the 34th week:preventive cervical cerclage:7cases,emergent cervical cerclage:2cases,non-cervical cerclage:6cases.(5) Presence of full-term labor:preventive cervical cerclage:4cases,emergent cervical cerclage:1cases,noncervical cerclage:3cases.(6) Presence of premature of membranes:preventive cervical cerclage:0cases,emergent cervical cerclage:4cases,non-cervical cerclage:0cases.Conclusion:Cervical incompetence is the common cause of miscarriage and premature birth in late pregnancy.Preventive cervical cerclage can increased the chance of giving birth after the 34th week,decreased the chance of PROM,increased the birth weight of newborns,but can not decrease the chance of preterm labor.For patients with low risk,conservative treatment can also obtain a better perinatal outcome.