Emergency cervical cerclage: a study between duration of cerclage in situ with gestation at cerclage, herniation of forewater, and cervical dilatation at presentation

Abstract

Objective: To investigate the effectiveness of emergency cerclage in prolonging pregnancy and its effect on pregnancy outcome in patients with cervical incompetence.

Study design: Retrospective review of patients who had emergency cervical cerclage performed for cervical incompetence. 19 patients between 16 and 30 weeks' gestation with (1) cervical effacement, (2) cervical dilatation of at least 1 cm, (3) herniation of intact fetal membranes through the cervical os, (4) absence of established labor, and (5) absence of clinical evidence of infection were studied. The duration of cerclage in situ, gestation at delivery and birth weight were analyzed.

Results: The mean duration of cerclage in situ was 47.5+/-48.6 days. The mean gestation at delivery was 30.5+/-6.6 weeks and the mean birth weight was 1730+/-1105 grams. The duration of cerclage in situ was significantly longer when the procedure was performed at or before 20 weeks' gestation (Mann-Whitney U test, P<0.02), or when there had been no herniation of forewater (HFW) at the time of presentation (Mann-Whitney U test, P<0.05).

Conclusions: Gestation at cerclage and the presence of herniation of forewater (HFW) at presentation of cervical incompetence significantly affect the duration of emergency cerclage in situ.