Cervical Cerclage and it's Significance in Preventing Second Trimester Abortions because of Cervical Incompetence


Authors : Dr. Sahar Syeed; Dr. Sameer Ahmad; Dr. Shakir Rasool Khan; Dr. Mahak Bhat

Volume/Issue : Volume 8 - 2023, Issue 3 - March

Google Scholar : https://bit.ly/3TmGbDi

Scribd : https://bit.ly/437CTs2

DOI : https://doi.org/10.5281/zenodo.7809268

Abstract : Cervical incompetence has been recognized as the leading cause of recurrent abortions in mid trimester. The elective cerclage based on history and clinical findings applied in second trimester overcomes the risk of emergency procedure. This problem is quite common in patients visiting department of Obstetrics and Gynaecology, Govt Medical College Srinagar LD Hospital.  Objectives: Assess gestational age at delivery after elective cervical cerclage application in mothers with recurrent mid trimester abortions. List the immediate and late complications of cerclage. Assess the fetal outcome after cerclage.  Outcome Measures:  Percentage of mid trimester abortion in current pregnancy.  Frequency of prolongation of gestational age at delivery.  Complications of the procedure.  Birth weight of the baby.  Percentage of live births.  Fetal survival rate.  Study Design:  Interventional: Quasi experimental study.  Setting: Department of Obstetrics and Gynaecology, Govt Medical College Srinagar LD Hospital.  Period: March 2022to March 2023.  Subjects: Fifty patients with recurrent mid trimester miscarriage due to cervical incompetence.  Methods: Patients were admitted through outdoor with history of previous mid trimester abortions possibly due to cervical incompetence. USG evidence of normal pregnancy with no obvious congenital anomaly was a pre requisite for cervical cercalge. Technique used was MCDonald’s suture under general anaesthesia. Results: Effectiveness of cerclage was 90%; 78% had term deliveries, 12% preterm delivery and 5 spontaneous mid trimester abortions. There were 81% live births. The complications included cervical trauma after delivery (2%), spontaneous abortions (10%), pre term delivery (13%) and pre prom (2%). Conclusion: Elective cerclage at 12-14 wks of gestation in recurrent mid trimester abortions results in good fetomaternal outcome with almost no complications.

Keywords : Cervical Incompetence, Elective Cervical Cerclage, McDonald’s Stitch.

Cervical incompetence has been recognized as the leading cause of recurrent abortions in mid trimester. The elective cerclage based on history and clinical findings applied in second trimester overcomes the risk of emergency procedure. This problem is quite common in patients visiting department of Obstetrics and Gynaecology, Govt Medical College Srinagar LD Hospital.  Objectives: Assess gestational age at delivery after elective cervical cerclage application in mothers with recurrent mid trimester abortions. List the immediate and late complications of cerclage. Assess the fetal outcome after cerclage.  Outcome Measures:  Percentage of mid trimester abortion in current pregnancy.  Frequency of prolongation of gestational age at delivery.  Complications of the procedure.  Birth weight of the baby.  Percentage of live births.  Fetal survival rate.  Study Design:  Interventional: Quasi experimental study.  Setting: Department of Obstetrics and Gynaecology, Govt Medical College Srinagar LD Hospital.  Period: March 2022to March 2023.  Subjects: Fifty patients with recurrent mid trimester miscarriage due to cervical incompetence.  Methods: Patients were admitted through outdoor with history of previous mid trimester abortions possibly due to cervical incompetence. USG evidence of normal pregnancy with no obvious congenital anomaly was a pre requisite for cervical cercalge. Technique used was MCDonald’s suture under general anaesthesia. Results: Effectiveness of cerclage was 90%; 78% had term deliveries, 12% preterm delivery and 5 spontaneous mid trimester abortions. There were 81% live births. The complications included cervical trauma after delivery (2%), spontaneous abortions (10%), pre term delivery (13%) and pre prom (2%). Conclusion: Elective cerclage at 12-14 wks of gestation in recurrent mid trimester abortions results in good fetomaternal outcome with almost no complications.

Keywords : Cervical Incompetence, Elective Cervical Cerclage, McDonald’s Stitch.

Never miss an update from Papermashup

Get notified about the latest tutorials and downloads.

Subscribe by Email

Get alerts directly into your inbox after each post and stay updated.
Subscribe
OR

Subscribe by RSS

Add our RSS to your feedreader to get regular updates from us.
Subscribe