Outcome of Mid - Trimester Emergency Cervical Cerclage

Objective: To evaluate the role of emergency cervical cerclage in prolongation of pregnancy and its effect on pregnancy outcome. Type of Study: a prospective clinical trial. Location: Tertiary Center Hospital, during the period from March 2012 to May 2015. Subjects and Method: Twenty patients fulfilled the inclusion criteria (who presented with a dilated cervical or with or without bulging fetal membranes between 16 and 27 weeks) followed a set protocol of prophylactic antibiotics and tocolytics before and after application of the cerclage suture. In all procedures, the McDonald's technique was applied. Results: In general, Pregnancy was prolonged by 67.1+ 38.1 days (ranged from 0 to 118 days). For the survivors it was 88.3 + SD 15.8 days (ranged from 62to 118 days). In 75% of the patients (N=15) pregnancy was prolonged beyond 31 weeks gestation with seventeen survivors (two set of twins). The mean gestational age at delivery was 32.03 ±6.2 weeks (ranged from 20.2 to 39.5 weeks).For the survivors it was 35.5 ± 2.5weeks (ranged from 31 to 39.5 weeks). The mean birth weight at delivery 1879.2± 911.9gm (ranged from 390 to 3300gm). For the survivors it was 2333.3± 491gm (ranged from 1650 to 3300 gm). Conclusion: Emergency cervical cerclage is an effective obstetric procedure. Despite its associated potential complications, it is probably the only option for women presented with advanced cervical dilatation with or without prolapsed membranes. Nevertheless, it should be used judiciously and only after comprehensive patients evaluation and extensive counseling. [Mohammed Ali Mohammed. Outcome of Mid Trimester Emergency Cervical Cerclage. J Am Sci 2015;11(12):244-249]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 31. doi:10.7537/marsjas111215.31.