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Published:
Apr 14, 2014Keywords:
cervical cerclage interval outcome incompetence pregnancy
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A 5 year review of pregnancy outcome and interval to delivery after cervical cerclage in north-eastern Nigeria
Abstract
Background: Evidences have shown the value of cerclage in reducing preterm birth in women with cervical incompetence.
Aim: To document the pregnancy outcome in women with cervical incompetence after cerclage insertion and to determine the time interval to spontaneous delivery after elective removal of cerclage at term.
Methods: Singleton pregnancies with cervical cerclage were reviewed in Federal Medical Centre (FMC), Gombe and FMC, Yola from 1st January, 2002 to 31st December, 2006. There were 38 patients in the study. The mean age of the patients was 27 ± 4.3 years while the mean gestational age (GA) at cerclage insertion was 15 ± 3 weeks. Outcome of pregnancy and interval to spontaneous delivery after elective removal of cerclage at term were determined.
Results: Eighty nine percent had history of at least 2 mid-trimester miscarriages and only 7.9% had history of preterm birth. Mean GA at delivery was 37 ± 3 weeks and fetal salvage rate was 76.3%. Overall, twenty four (63%) of the pregnancies progressed to term. Fifteen (62.5%) of these had vaginal delivery after elective cerclage removal. The mean cerclage removal to delivery interval was 9.3 days and only 20% delivered within 48 hours after removal of cerclage. The morbidity rate following cerclage insertion was 42.1% with Preterm Premature Rupture of Membranes (PPROM) being the commonest morbidity.
Conclusion: Most pregnancies in patients with cervical incompetence progressed to term following cerclage insertion and only few of them delivered within 48 hours of removal.
Key words: cervical cerclage, interval, outcome, incompetence, pregnancy
Aim: To document the pregnancy outcome in women with cervical incompetence after cerclage insertion and to determine the time interval to spontaneous delivery after elective removal of cerclage at term.
Methods: Singleton pregnancies with cervical cerclage were reviewed in Federal Medical Centre (FMC), Gombe and FMC, Yola from 1st January, 2002 to 31st December, 2006. There were 38 patients in the study. The mean age of the patients was 27 ± 4.3 years while the mean gestational age (GA) at cerclage insertion was 15 ± 3 weeks. Outcome of pregnancy and interval to spontaneous delivery after elective removal of cerclage at term were determined.
Results: Eighty nine percent had history of at least 2 mid-trimester miscarriages and only 7.9% had history of preterm birth. Mean GA at delivery was 37 ± 3 weeks and fetal salvage rate was 76.3%. Overall, twenty four (63%) of the pregnancies progressed to term. Fifteen (62.5%) of these had vaginal delivery after elective cerclage removal. The mean cerclage removal to delivery interval was 9.3 days and only 20% delivered within 48 hours after removal of cerclage. The morbidity rate following cerclage insertion was 42.1% with Preterm Premature Rupture of Membranes (PPROM) being the commonest morbidity.
Conclusion: Most pregnancies in patients with cervical incompetence progressed to term following cerclage insertion and only few of them delivered within 48 hours of removal.
Key words: cervical cerclage, interval, outcome, incompetence, pregnancy
