Role of Cervical Cerclage in Cervical Incompetence

OBJECTIVE: To determine the etiological factors, clinical presentation and pregnancy outcome in women who underwent cervical cerclage for incompetent cervix. SETTING: Obstetrics and Gynaecology Unit-II, Liaquat University Hospital, Hyderabad-Pakistan. Data records from January 2004 to December 2006 were analysed. STUDY DESIGN: A retrospective study. MATERIAL METHODS: The case files and OPD records of the cases of cervical incompetence were studies and data were recorded on a precoded proforma regarding patient’s past obstetrical history, gestational age and cervical dilatation at the time cerclage placement, complications and pregnancy outcomes. RESULT: Among 3033 patients admitted in the hospital 55 were diagnosed to have cervical incompetence, hence incidence come out 1.81%. In 41 patients cervical cerclage was applied, the method was “McDonald purse string suture”. Out of 41 patient’s miscarriage, pre-term and term delivery were 2.43%, 65.85% and 39.02% respectively. Foetal survival was 82.92%. No effect was seen on mode of delivery. There were no serious maternal complications. CONCLUSIONS: Past history of recurrent mid-trimester abortion or pre-term delivery when combine with ultrasonography form reliable basis for diagnosis. Cervical cerclage seems to be the effective treatment of choice in patients with cervical incompetence.