Pregnancy outcomes following placement of elective, urgent and emergent cerclage

Abstract

Objective. To describe pregnancy outcomes following elective (history-indicated), urgent (ultrasound-indicated) or emergent (physical-exam indicated) cerclage placement.

Materials and Methods. Study design was retrospective chart review. Women with singleton gestation and cervical cerclage were categorised into: elective, urgent and emergent group.

Results. One hundred and thirty-three women were included; 89 in elective, 26 in urgent and 18 in emergent group. Difference was detected when elective and urgent groups were compared with emergent group for: gestation at delivery (35.9 ± 5.1 vs. 34.2 ± 5.9 vs. 29.3 ± 7.2 weeks, respectively, P < 0.05), delivery beyond 36 weeks, (73.9%, 57.7%vs. 23.5%, respectively, P < 0.05), neonatal death (6.8%, 9.5%vs. 43.8%, respectively, P < 0.05) and Apgar score <7 at 5 min (9.1%, 11.5%vs. 47.1%, respectively, P < 0.05). Difference was also detected between elective vs. urgent and emergent groups for: preterm premature rupture of membranes (PPROM) (19.3%vs. 38.5%vs. 64.7%, respectively, P < 0.05) and chorioamnionitis (1.4%vs. 18.2%vs. 42.9%, respectively, P < 0.05).

Conclusions. Emergent cerclage group had the poorest obstetric outcomes. The urgent cerclage group reached similar gestational age at delivery as the elective group but is more likely to have PPROM and chorioamnionitis.

Keywords:

• Second trimester loss
• cerclage
• pregnancy outcomes