Emergency Cervical Cerclage: A Retrospective Study of 5 Years' Practice in 71 Cases

Kim, Jung Man; Lee, Keun Young; Kim, Ji Yeon; Kim, Jung Sik; Jun, Hyun Ah; Kim, Hong Bae; Kang, Song Won

Abstract

OBJECTIVE
We investigated the outcome of emergency cervical cerclage in women with cervical incompetence. Cervical incompetence was diagnosed when cervical dilatation exceeded 2 cm with intact but bulging membranes.
METHODS
Retrospective chart review of 71 cases of patients who underwent emergency cervical cerclage using Mcdonald suture after amnioreduction performed for cervical incompetence with cervical dilatation and membrane bulging from March 1998 through August 2003 at Kang-Nam Sacred Heart Hospital, Hallym University. Clinical variables evaluated included gestational age at cerclage, cervical dilatationa at cerclage, prolongation of pregnancy, and neonatal outcome.
RESULTS
Emergency cerclage was performed successfully in 67 cases (94%). Gestational age at cerclage ranged from 16 weeks to 29 weeks, with the mean being 23.6 +/- 3.3 weeks. Cervical dilatation at cerclage was between 2 cm and 9 cm (mean 3.8 +/- 1.6 cm). Gestational age at delivery ranged from 16 to 40 weeks (mean 28.2 +/- 6.0 weeks). Prolongation of pregnancy following cerclage varied from between 1 to 134 days (mean 31.5 +/- 33.1 days). The median birth weight was 1370.29 +/- 72.6 g (range 140-3640 g). Thirty-seven babies were born live, and 30 of them survived (survival rate 49%).
CONCLUSION
The possibility of a 49% survival rate is considered a good result for emergency cerclage. Emergency cervical cerclage can prolong pregnancy and influence the outcome of pregnancy favorably, and may be considered one potential method of treatment in such cases.