The value of cervical cerclage in preventing pregnancy loss

الملخص EN

Objective : To determine the value of cervical cerclage in preventing pregnancy loss in patients with presumed cervical incompetence.

Design : Retrospective study.

Setting : Department of Obstetrics and Gynecology, Bahrain Defense Force Hospital.

Method :The study was performed from 1January 2009 to 30 May 2010.

Fifty-six patients with a history of previous pregnancy loss, and patients with multiple pregnancies following assisted conceptions were included in the study.

Obstetrics data were obtained from clinical and surgical record.

The McDonald technique cerclage was used.

The gestational age at cerclage insertion was recorded.

The cerclage was removed electively at 36-37 weeks or sooner as events detected.

Result : Thirteen (23.2 %) patients had multiple pregnancies following assisted conception.

Three (5.4 %) had spontaneous abortion, twenty-two (39.3 %) had preterm delivery, before 37 weeks, of these nine were the result of pregnancies following assisted conceptions, thirty-one (55.3 %) reached term(37+weeks),thirty-four (60.7 %) had vaginal delivery of which seven (20.6 %) had their labor induced between 38-41 weeks.

Nineteen (33.9 %) patients were delivered by Caesarian section.

Sixty-one babies were delivered in this period ; nine neonates required intubation and admitted to intensive care unit because of prematurity and one death due to extreme prematurity of 26 weeks.

In patients who had the cerclage removal electively,24 (42.9 %) went into labor within 24hours ; and 30 (53.6 %) went into labor between 24 hours and 33 days.

Conclusion : Cervical cerclage is preventive in singleton pregnancy with short and incompetent cervix or in patients who had obstetric history.

No benefit was observed for the use of cerclage in multiple pregnancies following assisted conceptions.