A Clinical Significance of Emergency Cerclage for Patients with Advanced Painless Cervical Dilatation

Lee, Dong Ock; Chung, Youn Kyung; Cho, Hyon Il; Shim, Soon Sup; Park, Joong Shin; Jun, Jong Kwan; Yoon, Bo Hyun; Syn, Hee Chul

Abstract

OBJECTIVE
To assess the clinical significance of emergency cerclage in the patients with advenced painless cervical dilatation.
METHODS
We performed the analysis of the pregnancy outcomes of the 14 patients who underwent emergency cerclage between January 1990 and December 2001 at Seoul National University Hospital. Only singleton pregnancies were included. We compared these results with those of the 56 patients who underwent elective cerclage in the same period.
RESULTS
In the patients with emergency cerclage, mean gestational age at cerclage was 20.71 +/- 3.24 weeks and mean gestational age at delivery was 29.84 +/- 7.40 weeks. The mean cerclage-to-delivery interval was 9.14 +/- 7.53 weeks and overall perinatal survival rate was 63.4%. After cerclage, rupture of membrane occurred in 2 cases (14.3%), preterm labor developed in 8 cases (57.1%) and slipping out of cerclage suture developed in 3 cases (21.4%). In comparison with elective cerclage, mean gestational age at delivery, interval between cerclage and delivery, Apgar scores at birth, perinatal death, preterm delivery rate before 28 and 32 weeks' gestation and neonatal birth weight showed worse outcome in emergency cerclage group than elective cerclage group.
CONCLUSION
Although emergency cerclage shows worse outcomes than elective cerclage, it seems to be optional treatment modality for patients with painless cervical dilatation considering pregnancy prdongation and neonatal survival.