Emergency cervical cerclage in advanced cervical incompetence / 대한산부인과학회지

ABSTRACT

OBJECTIVE: To investigate the clinical effectiveness of emergency cervical cerclage in pregnant women with advanced cervical incompetence in the second trimester. METHODS: This study analyzed retrospectively the pregnancy outcomes of 20 patients who were offered emergency cerclage between June 2000 and April 2004. Group I was defined as the patients cervical dilatation without membrane prolapse. Group II was the patients with membrane prolapse into vagina, who were underwent amniocentesis to decrease intraamniotic pressure. RESULTS: The mean+/-SD gestational age at cerclage was 21.6+/-2.4 weeks (Group I 21.0+/-2.5, Group II 22.1+/-2.3). The mean cervical dilatation was 2.5+/-0.9 cm (Group I 1.8+/-0.5, Group II 3.2+/-0.8) and mean effacement was 79.0+/-12.9% (Group I 68.8+/-11.6, Group II 87.3+/-6.4). The mean interval from cerclage to delivery was 9.4+/-5.3 weeks (Group I 11.1+/-6.1, Group II 7.9+/-3.7) and mean gestational age at delivery was 31.0+/-6.0 weeks (Group I 32.2+/-7.4, Group II 30.0+/-4.9). The birth weight was 1.9+/-1.1 kg (Group I 2.4+/-1.4, Group II 1.6+/-0.8) and the perinatal survival rate was 75% (Group I 77%, Group II 73%). Cervix dilatation and effacement were significantly more advanced in group II compared to the group I (p<0.05). However, the duration of pregnancy prolongation and birth weight, gestational age at the delivery were not significantly different between both groups. CONCLUSION: This results suggest that emergency cervical cerclage might be an effective treatment in advanced cervical incompetence, and that the concomitant amniocentesis could help the cerclage in the patients with membrane prolapse.