ABSTRACT
Cervical cerclage has been used as an emergency or 'rescue' suture in women presenting with dilated cervices in the mid-trimester attempting to prolong pregnancy and improving fetal Outcome. This study was conducted to assess efficacy of cervical cerclage in pregnancy prolongation and improving fetal/neonatal outcome in patients with cervical changes and/or herniation of the fetal membranes. During the period from January 2000 to December 2007, twenty seven women between 18 and 24 weeks pregnancy presented with cervical dilation and fulfilled the inclusion criteria underwent emergency cerclage. Two patients, however, were lost during follow-up and therefore the case group included 25 patients while the control group included 19 patients, who refused the procedure and were managed conservatively with bed rest alone. The 2 groups were compared with regard to duration of pregnancy prolongation, gestational age at delivery, and neonatal birth weight. In the cerclage group, the mean prolongation of pregnancy was 69.28 days, the mean gestational age at delivery was 30.71 weeks, and the mean birth weight was 1843gm. These measures were significantly different from those of the control group [39 days, 26.43 weeks, and 1064gm, respectively]. Twenty of the 25 pregnancies in the cerclage group ended in live births, while 10 of the 19 pregnancies in the control group ended in live births [P>0.05]. Emergency cervical cerciage in the presence of bulging fetal membranes can be carried out safely. It resulted in prolongation of pregnancy, increased gestational age at delivery and improved neonatal outcome