Effectiveness of cervical encerclage and its perinatal outcome-A cohort study

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Original Article

Author :

Indu M Madhu*, Anoj Kattukaran, Susan Thomas

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Abstract :

Introduction: Cervical incompetence is the inability of cervix to support a full term pregnancy. The patient presents with a partially dilated cervix, with or without a history of recurrent mid trimester losses or preterm births. It is believed thatthe forced mechanical closure of an ‘incompetent’ cervix with a suture maintains the cervical length, thus preventing preterm labor. Objectives: To evaluate effectiveness of cervical encerclage in women with cervical incompetence and its perinatal outcomes. Materials and Methods: This ambispective cohort study was conducted in the department of Obstetrics and Gynecology, Amala Institute of Medical Sciences, Thrissur. Medical records were reviewed during the period of 2008-201. 79 cases were included in this study. Clinical data, gestational age, cervical dilatation at the time of cerclage, cerclage-delivery interval, gestational age at the time of delivery, birth weight and maternal complications, were collected. Results: Mean gestational age at the time of cerclage is 18.686 ±4.0200 weeks. Mean cerclage - delivery interval is18.510 ±6.3026 weeks. Cerclage delivery interval in prophylactic cases is 20.13 ±3.79 weeks and in rescue cerclages it is 9.487± 2.73 weeks. Prophylactic cerclage is more effective than rescue cerclages (p=0.0002). Mean gestational age at delivery is 36.666 ±5.3354 weeks. 23cases (29%) had low birth weight babies ( Conclusion: Based on this study we conclude that cerclage is beneficial in prolonging pregnancy with a consequent reduction of fetal losses and neonatal deaths.  

Keyword :

Cervical encerclage, Cervical insufficiency.
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