July 29th, 2014

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Title:
Results of Midtrimester Emergency Cerclage
Authors:  Nilgün Güdücü, M.D., Herman I·sçi, M.D., and Kiliç Aydinli, M.D.
  OBJECTIVE: To evaluate the outcomes of midtrimester emergency cerclage and to find out the contributing factors.

STUDY DESIGN: Twenty-five patients presenting with cervical dilation and effacement with the membranes at the level of the external os or prolapsed into the vagina were included in the study. At the time of the cervical cerclage placement, gestational age ranged from 14–26 weeks. A good outcome was defined as the take-home baby rate, but also the interval between the time of the cervical cerclage placement and delivery and the gestational age at delivery were discussed.

RESULTS: The mean gestational age at the time of the cervical cerclage placement was 21.2±2.73 weeks, the mean gestational age at delivery was 29.4±5.37 weeks, and the mean birth weight was 1,511 g. Eighteen patients had McDonald type cerclage, and 7 patients had both McDonald and Saling type cerclages. The overall take-home baby rate was 64%. Patients presenting with membranes at the level of external os had a take-home baby rate of 68.8%, whereas patients presenting with membranes prolapsed into the vagina had a take-home baby rate of 31.3%.

CONCLUSION: Cervical dilation at midtrimester has a poor outcome which can be improved with emergency cerclage. Patients presenting with membranes prolapsed into the vagina have a decreased success rate. Total closure of the cervix may improve results.
Keywords:  cervical cerclage; emergency cerclage; pregnancy complications; pregnancy, twin
   
   
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