Evaluation of cervical cerclage for sonographically incompetent cervix in at high risk patients

ABSTRACT

To determine the impact of Cervical Cerclage [CC] for prolongation of pregnancy, maternal and foetal outcome. This Descriptive cross-sectional study was conducted over a period of 2 years patients with history of two or more recurrent midtrimester abortions/preterm deliveries were included. Those with abnormal foetus, vaginal bleeding and choreoamneonitis were excluded. All patients were subjected to transvaginal sonography. Those having sonographic evidence of cervical shortening/dilatation/cone formation were subjected to McDonald suture. Age, parity, period of gestation and aetiological factors were determined. Results were evaluated on the basis of pregnancy prolongation, 14-28 weeks [7.5%], 28-36 weeks [18.7%], 35-37 weeks [73.7%],vaginal delivery in [70%], instrumental [13.05%], Caesarean section [17.5%],miscarriage [7.5%], prematurity [18.7%], term delivery [73.7%], prenatal death [13.7%], foetal survival rate [85.1%]. No intraoperative complication found. During pregnancy premature rupture of membrane [3.7%], abruption [2.5%], severe pre-eclampsia [3.7%]. During labour cervical dystocia was found in [2.5%], foetal distress [8.7%], mal-presentations [6.2%], cervical trauma [3.7%]. We determined a high success rate of cervical cerclage on properly selected patients with sonographic evidence of cervical changes. Cervical sonography can be a valuable adjunct to clinical evaluation of these patients