Randomized comparative study between pregnant women with early serial transvaginal ultrasonography versus early cerclage on the outcome of pregnancy, in those with an unclear history of incompetent cervix

ABSTRACT

Forty women with an unclear history of incompetent cervix [women with single second trimester termination or unexplained loss] and those with three or more first trimester terminations were randomly distributed into two groups Group I included ten women who underwent early elective cervical cerclage [15 weeks] to be compared with the other thirty women [group II] with the same unclear history of cervical incompetence who underwent early serial transvaginal ultrasonography for the detection of cervical changes [two or more examinations before 20 weeks]. Latte therapeutic cervical cerclage was done for women who had evident cervical shortening and or funneling detected by transvaginal ultrasonographic examination. The primary outcome variable was gestational age at delivery. Demographic variables and the data collected from the obstetric history between the two groups were nearly similar, with no statistically significant difference. The frequencies of preterm labor and preterm rupture of membranes were high in group I [elective cervical cerclage] than in group II [early serial transvaginal ultrasonographic examination] and the differences were statistically significant. The mean gestational age at delivery was 35.2 + 3.5 weeks for the early elective cervical cerclage women [group I] versus 36 + 4.0 weeks for the early serial transvaginal ultrasonography women [group II] with no significant difference in between