Korean J Perinatol.  2010 Mar;21(1):59-65.

Management of Cervical Incompetence with Bulging Fetal Membranes : Emergency Cerclage Versus Bed Rest

• Jo YS
• Chung HS
• Lee GS
• Kim SJ

Abstract

PURPOSE
To compare clinical outcomes after management with bed rest versus cerclage for treatment of amniotic sac bulging in the second trimester.
METHODS
Women with cervical incompetence with membranes at or beyond a dilated external cervical os, before 27weeks of gestation, were treated with bed rest or emergency cerclage. We analyzed the pregnancy outcome retrospectively. 25 women underwent an emergency cerclege and 35 women underwent the bed rest.
RESULTS
Gestational age at time of diagnosis was 22.40 weeks in the emergency cerclage and 22.39 weeks in the bed rest group. Mean interval from diagnosis until delivery was 8.65 weeks in the emergency cerclage group and 1.18 weeks in the bed rest group (p<0.001). Mean gestational age at delivery was 31 weeks in emergency cerclage group and 23.74 weeks in the bed rest group (p<0.001). Preterm delivery before 26 weeks and 34 weeks of gestation were significantly lower in the emergency cerclage group (p<0.001). Perinatal mortality was 17.4% in the emergency cerclage group and 48.6% in bed rest group (P=0.026).
CONCLUSION
Emergency cerclage reduced preterm delivery before 26 and 34 weeks and improved perinatal outcome compared with bed rest treatment.

Keyword

Cervical incompetence; Bulging fetal membrane; Emergency cerclage

MeSH Terms

Bed Rest
Emergencies
Extraembryonic Membranes
Female
Gestational Age
Humans
Membranes
Perinatal Mortality
Pregnancy
Pregnancy Outcome
Pregnancy Trimester, Second
Retrospective Studies