Cervical incompetence and pregnancy outcome in Jos University Teaching Hospital: A four-year review

Abstract

Background: Cervical incompetence continues to pose a challenge to the obstetrican as a cause of repeated midtrimester abortion. Several observational studies into the efficacy of cervical Cerclage have claimed high rates of successful pregnancy outcome in  women with poor obstetric history attributed to cervical incompetence.

Objectives: The objectives of the study are to determine the prevalence of cervical incompetence in Jos University Teaching Hospital (JUTH), the complications of the treatment modalities, and the  pregnancy outcome.

Study design, setting and subject: This is a 4 years retrospective review of 144 pregnancies in (135) patients with  cervical incompetence in the Jos University Teaching Hospital. Patients diagnosed to have cervical incompetence and who had cervical Cerclage, antenatal care and delivery in the Jos University Teaching Hospital, Jos, formed the study population.

Main outcome  measures: Prevalence, post insertion complications and Pregnancy outcome, among patients with cervical incompetence who had cervical  cerclage in Jos University Teaching Hospital, Jos Plateau state.

Results: A total of one hundred and fourty four pregnancies were reviewed retrospectively in one hundred and thirty five patients with cervical incompetence over a four-year period. The diagnosis of  cervical incompetence was established by history 63% of pregnancies, and by ultra-sonography in 35% of pregnancies. The McDonald  technique of repair was employed in 90% of the cases. The incidence of cervical incompetence over the period of review was 1 in every 69  deliveries. The most common post insertion complications were premature rupture of membranes (20.8%) Vulvovaginitis (16%) and  urinary tract infection (10.5%). The term births accounted for 62.5% and preterm births for 22.9%, with overall fetal salvage of 85.4%.