Li-Qiong Zhu, Hui Chen, Li-Bin Chen, Ying-Lin Liu, Jian-Ping Tian, Yun-Hui Wang, Rui Zhang, Jian-Ping Zhang
Department of Obstetrics and Gynecology, un Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China (mainland)
Med Sci Monit 2015; 21:1395-1401
The aim of this study was to evaluate the effectiveness and safety of emergency cervical cerclage in women with advanced cervical dilatation and bulging of fetal membranes. The study included 158 women who underwent emergency cervical cerclage because of cervix dilatation and protruding membranes in mid-trimester at Sun Yat-sen Memorial Hospital of Sun Yat-sen University. Pregnancy outcomes and pregnancy outcome related to clinical features were analyzed retrospectively. Analysis revealed that the placement of emergency cerclage led to the delivery of live infants with a success rate of 82.28%. The mean interval between cerclage and delivery was 52.16.±26.62 days, with a mean gestation at delivery of 30.3±4.7 weeks and a mean birth weight of 1934.69±570.37 g. No severe maternal complications such as maternal death, hematosepsis, and hysterorrhexis occurred after the operation. Two women (1.25%) had laceration of the cervix, 1 woman (0.61%) suffered pulmonary edema, and 2 women (1.25%) developed deep vein thrombosis (DVT). There were significant correlations between the pregnancy outcome and risk factors, including any presenting symptoms, cervical dilatation, postoperative white blood cell count, and C-reactive protein (CRP) value. No significant difference was found in women with good vs. poor outcome in terms of maternal age and obstetric histories. Emergency cervical cerclage is effective in prolonging pregnancy and improving neonatal outcome in women with cervical incompetence. It should be considered a viable option for women with a dilated cervix in mid-trimester.
Keywords: Antibiotic Prophylaxis, Adult, Birth Weight, C-Reactive Protein - analysis, Cerclage, Cervical, Emergencies, Gestational Age, Infant, Newborn, Leukocyte Count, Obstetric Labor, Premature - prevention & control, Preanesthetic Medication, Pregnancy, Pregnancy Complications - epidemiology, Pregnancy Outcome, Pregnancy Trimester, Second, Pulmonary Edema - epidemiology, Thrombophlebitis - epidemiology, Tocolytic Agents - administration & dosage, Uterine Cervical Incompetence - surgery, young adult