Clinical analysis of cervical cerclage treated cervical insufficiency to prevent premature delivery
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Objective:To compare the clinical therapeutic effects of cervical cerclage and bed rest to prevent preterm delivery on pregnants with cervical insufficiency.Methods:Applying retrospective study,we collected the medical history information on 83 women diagnosised as cervical insufficiency from 2005 to 2007 in the department of gynaecology and obstetrics of our hospital.In 83 women,55 women assigned to receive cervical cerclage(A group),28 women assigned to receive bed rest(B group).Results:Preterm delievery before 34 weeks of gestation occurred in 7 of 55 women (90.90%) treated with cervical cerclage,and in 4 of 28 women (21.43%) treated with bed rest.There was significant difference in gestation age at delivery between the 2 groups.Conclusion:Cervical cerclage is an effective approach to treat cervical insufficiency and prevent preterm delivery.Keywords:
Cervical insufficiency
Cervical cerclage
Rest (music)
Cervical dilatation
Preterm labour
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Cervical insufficiency is a well documented etiological factor in preterm delivery. This study was conducted to evaluate the efficacy and safety of Emergency cervical cerclage in women who presented with advanced cervical changes such as cervical dilatation and bulging fetal membranes. The study was prospective observational study performed in the department of obstetrics and gynaecology CSI Kalyani General Hospital, Chennai, Tamil Nadu over a duration of 18 months. This study included all women who presented in late second trimester with advanced cervical dilatation (2 to 4cms) for whom emergency cervical cerclage was done by McDonald technique. Out of the 15 patients for whom emergency cerclage was performed, 3 had spontanous abortion after cerclage, 6 had PROM and 5 of these patients had term delivery. The time interval between emergency cervical cerclage and delivery was 11 weeks. No surgical complications were reported. The mean gestational age at delivery was 32 weeks. 11 fetuses were live born after the period of viability. 3 of these babies were admitted to NICU. Post emergency cervical cerclage, the outcomes in terms of prolongation of pregnancy, live births and neonatal survival are better.
Cervical cerclage
Cervical insufficiency
Cervical dilatation
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Cervical cerclage
Cervical insufficiency
Second trimester
Premature birth
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Cervical cerclage
Center (category theory)
Single Center
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The Perinatal morbidity and mortality associated with pre-term delivery is well known. Cervical incompetence or short cervix is a risk factor for the condition and cervical cerclage is the management option for such cases. The objective of the study was to determine the frequency of operative morbidities of cervical cerclage. All women undergoing cervical cerclage from April 2007 to December 2009 at the Aga Khan University Hospital served as the study subjects. Findings suggested that the risk of developing ruptured membranes after cervical cerclage was 10% and that of pregnancy loss was 8.6%. The risk of cerclage-associated complications like rupture of membranes, bleeding and chorioamnionitis was small. The risk of delivery before 34 weeks of gestation was 15.7%.
Cervical cerclage
Chorioamnionitis
Cervical insufficiency
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Objective To evaluate the effect of emergency cervical cerclage treatment on preterm labor with cervical incompetence.Methods Select 36 cases occurring in our hospital from 2004 to 2009 with preterm labor because cervical incompetence before their 32th gestational weeks to study,of these there were 22 cases as a groups which accepted emergency cervical cerclage and tocolytic(magnesium sulfate),while the other 14 cases as another group which accepted tocolytic only,then analyze the treatment of the two groups.Results The group treated with emergency cervical cerclage and tocolytic prolonged gestation by 52 days in mean,and the group treated with tocolytic only prolonged gestation by 9 days in mean.The patients treated with emergency cervical cerclage and tocolytic prolonged obviously gestation days,and the delivery rate after the 34th week and the 37th weeks(P0.05)also increased.Conclusion The treatment effect with emergency cervical cerclage and tocolytic on preterm labor with cervical incompetence is better;it enhanced the delivery rate after 34th week,reduced the premature delivery rate and improved neonatal livability.
Cervical cerclage
Tocolytic
Tocolytic agent
Cervical dilatation
Preterm labour
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Background: Preterm labour and mid-trimester abortions are very common problems and one of the common reasons considered is cervical incompetence. Cervical cerclage is the modality of treatment for cervical incompetence apart from progesterone supplementation though both were associated with occasional poor outcomes. Cervical cerclage is being discussed here.
Objective: To determine poor prognostic factors for cervical cerclage and when to apply cervical cerclage on the basis of cervical length.
Materials and methods: This is a retrospective study done in the Department of Reproductive Medicine Bansal hospital Bhopal. We studied all Shirodkar cerclage procedure done in our department from May 2015 to December 2020. A total of 49 patients were included in the study with whom the delivery outcome was available.
Results:
Emergency cerclage had the highest failure rate - 7 out of 8 patients delivered before the period of viability.
Cervical cerclage was done in 14 twin pregnancies out of which six aborted. In six aborted twins, three had emergency cerclage. So twin gestation is second risk factor for failure.
All primigravida patients with cervical length between 20-25 mm had delivery at term. Patients with cervical length below 20 mm had delivery before 36 weeks.
Conclusion: We have found that two worst prognostic factors for the success of cerclage are emergency cerclage and twin gestation. We had not found any benefit of cerclage in primigravi-da patients with a cervical length above 20 mm. Although being a small retrospective study it is difficult to draw a conclusion.
Keywords: Shirodkar cerclage; Mid trimester abortion; Cervical length; Emergency cerclage; Twin gestation
Cervical cerclage
Cervical insufficiency
Cervical dilatation
Second trimester
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Context : Cervical incompetence is a major cause of recurrent mid-trimester pregnancy loss and preterm deliveries; it contributes significantly to fetal loss and neonatal morbidity and mortality. Despite its wide use, the effectiveness of cervical cerclage in its management remains unsettled. Objective : To evaluate the effectiveness of cervical cerclage by comparing the pregnancy outcome before and after its insertion in women with cervical incompetence. Study design : An observational study [retrospective] of 95 women diagnosed with cervical incompetence that had cervical cerclage inserted from 1st January 2007 to31st December 2010. The pregnancy outcome before and after cervical cerclage were compared, the data was analyzed using SPSS version 18; p value <0.05 was considered significant. Main outcome measure : The gestational age at the end of pregnancy, the duration of prolongation of the pregnancy after cervical cerclage and the pregnancy outcome. Results : Of 103 cases of cervical incompetence managed, 95 satisfied the inclusion criteria. The prevalence of cervical incompetence was 8.4/1000 deliveries or 0.85%. There were 85 elective and 10 emergency cerclage with mean gestational age at end of pregnancy of 36.06±3.96 vs. 25.10±3.99 and mean duration of prolongation of pregnancy 20.98±4.71 vs. 4.00±3.37 weeks. After cervical cerclage insertion, there was reduction in miscarriages [P<0.0001] and preterm deliveries [P<0.0001] and increase in term deliveries [P=0.4100] and viable pregnancies [P=0.001]. The child take home rate was 89.4% following elective and 20% after emergency cervical cerclage. Conclusion : Cervical cerclage resulted in improved pregnancy outcome in women with previous midtrimester losses or preterm delivery. Keywords : Cervical cerclage; cervical incompetence; pregnancy outcome; intervention.
Cervical cerclage
Cervical insufficiency
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Cervical cerclage
Singleton
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Objective: The aim of this study is to compare the perinatal outcomes of double cerclage via laparoscopic plus transvaginal technique in women with a history of transvaginal cerclage failure, between women with single transvaginal cerclage.Study Design: Five women who were diagnosed with cervical insufficiency with a history of at least one vaginal cerclage failure and 10 women who were diagnosed with cervical insufficiency were included in this study. Laparoscopic cerclage was performed to all women who have a medical history of vaginal cerclage failure, before pregnancy and additional transvaginal cervical cerclage was performed during their pregnancy (Group 1). Single transvaginal cervical cerclage was performed to the 10 women who had a short cervix and/or cervical insufficiency during their pregnancy (Group 2). The number of cerclage failure, perinatal outcomes, gestational week at the time of delivery, birth weight and Apgar scores were evaluated.Results: All five women in group 1 underwent a cesarean section. None of them had chorioamnionitis or poor obstetric outcomes and all gave birth after the 34th week of pregnancy. All ten women in group 2 were evaluated. Two women gave birth vaginally at the 33rd week of pregnancy. Remaining eight cases gave birth above 34th week of pregnancy. Six of the eight cases underwent cesarean section and two of the remaining were delivered vaginally. Mean birth weight of the fetuses were 2490±265 g and 2.710 ±361 g in group1 and group 2, respectively. Mean gestational age at the time of birth in group 1 and group 2 were found 36±1.83 weeks and 35.6±1.14 weeks, respectively.Conclusion: Laparoscopic cervical cerclage during pregnancy could be a safe and effective treatment. However, sometimes it might not be enough and transvaginal cervical cerclage may be needed to strengthen cervical tension.
Cervical insufficiency
Cervical cerclage
Chorioamnionitis
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Cervical cerclage
Cervical insufficiency
Cervical dilatation
Premature birth
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