COMPARISON OF SUCCESS AND MORBIDITY IN CERVICAL CERCLAGE PROCEDURES
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Abstract
Objective: To compare the success rate and morbidity of elective cervical cerclage with emergency cervical
cerclage.
Material and Methods: A prospective interventional study with seven definite indications for cervical cerclage under
taken over a five year period from July 2006 to June 2011 at Department of Obstetrics and Gynaecology, District
Headquarter Hospital, Mardan, Pakistan.
Result: Fifty-five women were studied of these 42(76.36%) had elective cerclage while 13(23.63%) emergency
cerclage. Complete medical record of these patients was retrieved. They ranged from 20-38 years of age with median
at 27 years. Ninty percent of patients presented at 12 to 24 week of gestation. Elective cerclage significantly improved
fetal survival rate in 35 (83%) of patients after elective cerclage versus 40(27%) of patients before cerclage (p<.000).
Fetal survival rate increased after emergency cerclage but the effect produced was not significant 15 (60%) of
patients versus 9 (69%) of patients (p=0.423). Pyrexia was the most common complication. Ceasarian section rate
was not increased in the cerclage group. Complication rate was higher in the emergency cerclage group 53.84%
versus16.66% in the elective cerclage group.
Conclusion: Prophylactic application of cervical cerclage is the best time especially in patients with previous history
of two or more than two midtrimester abortions or premature births and history of previous cerclage. The prematurity
and complications rate is higher in patient with emergency cerclage.
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