Pregnancy Outcome Following Cervical Encerclage Operation

Abstract

Background -Recurrent second trimester abortions and premature deliveries, continue to be two of the main problems of modern obstetrics and perinatal medicine. Cervical incompetency or insufficiency is defined as "the inability of the uterine cervix to retain a pregnancy in the absence of contractions or labor. Cervical encerclage is considered as a simple but useful minor surgical procedure for improving the fetal salvage in proven cases of cervical incompetence. Material and Methods-A prospective analytical study was carried out at tertiary care teaching hospital for a period of seven years. Sixty cases of bad obstetrical history (repeated abortions, preterm labour) with previous pregnancy losses probably due to cervical incompetence were included in the study .These cases were subjected to cervical encerclage operation at various gestational periods. Results-Out of total fifty cases, who underwent McDonald's procedure, 2 women had abortion, and 11 had preterm labour and 37 women reached to term. Out of the ten cases, who underwent Wurm's procedure, 1 women had abortion, 2 had preterm deliveries and 7 women reached to term. In the present study, the average interval from cerclage to delivery was 95 days. It was observed that the fetal salvage rate was unsatisfactory in women having short cervix with open internal os before cervical encerclage operation. Infant salvage rate in this study was 51.07% before and 84% after encerclage operation. Conclusion-Cervical encerclage done in properly selected cases, results in improvement in fetal salvage up to eighty percent.

Practice of Cervical Cerclage at a University Teaching Hospital in Southern Nigeria

“…The term cervical incompetence or insufficiency describing this event is defined as the inability of the uterine cervix to retain a pregnancy in the absence of uterine contractions or labour [2]. It is characterized by painless opening and shortening of the cervix uteri between 16 and 28 weeks of gestation resulting in fetal wastage [7]. Globally, the incidence of cervical incompetence varies from 1:54 to 1:222 pregnancies.…”

“…Globally, the incidence of cervical incompetence varies from 1:54 to 1:222 pregnancies. It is responsible for 15-20% abortions in the second trimester [7]. Other studies suggest the incidence of cervical incompetence varies with different population and it has been reported to complicate about 1% of all pregnancies but rises to 8% in those who suffered a second or third trimester pregnancy loss [4,5].…”