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. 2024 Apr;165(1):343-349.
doi: 10.1002/ijgo.15210. Epub 2023 Oct 30.

Perinatal outcomes in patients undergoing repeat cerclage: A retrospective case series study

Ping Ru  1 , Xiaotian Ni  1 , Wenyi Xu  1 , Yun Liu  1 , Lulu Meng  1 , Wenjun Yuan  2 , Zhuorong Gu  2 , Junyao Shi  3 , Xiujuan Su  4 , Ming Liu  1 , Tao Duan  1   5
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Perinatal outcomes in patients undergoing repeat cerclage: A retrospective case series study

Ping Ru et al. Int J Gynaecol Obstet. 2024 Apr.

Abstract

Objective: This study aimed to describe the pregnancy outcomes of a case series of patients with probable cerclage failure who received repeat cerclage (RC) with potential indications.

Methods: We retrospectively collected a case series of 55 singleton pregnancies with RC from 2019 to 2022 in Shanghai, China. All included women provided written informed consent, and the study was approved by the ethics committees of the two hospitals. We compared pregnancy outcomes between pregnancies with RC for different indications.

Results: Among the case series, nine patients underwent RC for the indication of protruding membranes below the previous suture loop (group A), and the other 46 patients for painless cervix dilation (group B). Gestational age at delivery was shorter in group B than in group A (30.7 vs 37.6 weeks, P = 0.009). Rates of preterm birth <32 weeks (63.0% vs 22.2%, P = 0.033) and < 37 weeks (76.1% vs 33.3%, P = 0.002) were significantly higher in group B than in group A. Of the 46 patients who underwent RC for painless cervical dilation, 28 had cervical dilation of 1 to 2 cm (group C) and the other 18 had cervical dilation of 3 to 6 cm (group D). The gestational age at delivery was shorter in group D than in group C (27.4 vs 31.5 weeks, P = 0.037). However, rates of preterm birth <32 or <37 weeks were similar between the groups.

Conclusion: RC may constitute a rescue strategy for patients with probable cerclage failure. Protrusion of membranes below the cerclage loop or cervical dilation <3 cm may be an indicator of better pregnancy outcome.

Keywords: bulging membranes; cerclage failure; cervical insufficiency; preterm birth; reinforcing cerclage; repeat cerclage.

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References

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