OALibJ  Vol.1 No.7 , October 2014
Pregnancy Outcomes Following Emergency Cervical Cerclage
Abstract: Background: The pregnancy outcome following cervical cerclage for women with cervical incompetence is generally favourable. However, the outcome for emergency cerclage is less favourable. Methodology: A retrospective analysis of the case notes of pregnant women who underwent emergency cervical cerclage from January 2007 until December 2010 at Garkuwa Hospital and Sheehan Hospital was performed. Results: There were a total of 56 cases of cervical cerclage comprising 46 elective and 10 emergency cervical cerclage respectively. The procedure prolonged pregnancy in all the patients with the mean duration of 38 days. The outcome for emergency cerclage was 3 stillbirths (IUFD) and 7 live births (6 survived with 1 early neonatal death). Neonatal outcome was good if the initial cervical dilatation was 4 cm or less. Conclusion: Favourable outcomes should be expected in carefully selected cases and all patients should be informed of the survival rates before undergoing this procedure.
Cite this paper: Ojabo, A. , Adesiyun, A. , Hembah-Hilekaan, S. , Mohammed-Durosinlorun, A. and Sulayman-Umar, H. (2014) Pregnancy Outcomes Following Emergency Cervical Cerclage. Open Access Library Journal, 1, 1-5. doi: 10.4236/oalib.1100970.

[1]   Jorgen, V.H. and Van Roosmalen, J. (1997) Complications of Cervical Cerclage in Rural Areas. International Journal of Gynecology and Obstetrics, 57, 23-26.

[2]   Osemwenkha, P.A. and Osaikhuwuomwan, J.A. (2014) Cervical Cerclage in a Nigerian Tertiary Hospital: A Review. Nigerian Journal of Surgical Sciences, 24, 1-6.

[3]   Feyi-Waboso, P.A. and Umezurike, C.C. (2005) Management of Cervical Incompetence in Aba, South-Eastern Nigeria. Nigerian Medical Journal, 14, 400-404.

[4]   Varghese, S., Myers, J., Juverdeanu, S., Kamran, M. and Gillham, J.C. (2010) Do Emergency Cervical Cerclages Make a Difference? A 10-Year Retrospective Study. Archives of Disease in Childhood, Fetal and Neonatal Edition, 95, Fa95.

[5]   Al-Takroni, A.M.B, Aslam, F, Parvathi, C.K., Shamdeen, M, Hanbali, M, Ahmed, S., Khatun, A., Ali, A.M., Mendis, K.B.L. (1999) Emergency Cervical Cerclage: A Review of 15 Cases. Annals of Saudi Medicine, 19, 23-26.

[6]   Wright, E.A. (1987) Fetal Salvage with Cervical Cerclage. International Journal of Gynecology and Obstetrics, 25, 13-16.

[7]   Srinivasan, M., Krishanan, R.N. and Lindow, S.W. (2011) Pregnancy Outcome Following Emergency Cervical Cerclage. Open Journal of Obstetrics and Gynecology, 1, 184-186.

[8]   Eskander, M.A., Sobande, A.A., Damole, I.O. and Bahar, A.M. (2004) Emergency Cervical Cerclage: Does the Gestational Age Make a Difference? Saudi Medical Journal, 25, 1028-1031.

[9]   Shirodkar, V.N. (1955) A New Method of Operative Treatment of Habitual Abortion. Antiseptic, 52, 299.

[10]   McDonald, I.A. (1957) Suture of the Cervix for Inevitable Miscarriage. BJOG: An International Journal of Obstetrics and Gynaecology, 64, 346-350.

[11]   Liddiard, A., Bhattacharya, S. and Crichton, L. (2011) Elective and Emergency Cervical Cerclage and Immediate Pregnancy Outcomes: A Retrospective Observational Study. Journal of the Royal Society of Medicine Short Report, 2, 91.

[12]   Jack, L. and John, O. (2007) Cervical Incompetence. In: Steven, G.G., Joe, L.S. and Jennifer, N., Eds., Obstetrics: Normal and Problem Pregnancies, 5th Edition, Churchill Livingstone, An Imprint of Elsevier, London, 1-18.

[13]   Stirat, G. (1995) Recurrent Miscarriage. In: Janer, D.K., Steer, P.J., Weiner, C.P. and Gonik, B.J., Eds., High Risk Pregnancy, Management Options, 1st Edition, WB Saunders, London, 101-117.

[14]   Srinivasan, M., Krishanan, N.R. and Lindow, S.W. (2011) Pregnancy Outcome Following Emergency Cervical Cerclage. Open Journal of Obstetrics and Gynecology, 1, 184-186.

[15]   Heath, V.C.F., Souka, A.P., Erasmus, I., Gibb, D.M.F. and Nicolaides, K.H. (1998) Cervical Length at 23 Weeks of Gestation: The Value of Shirodkar Suture for the Short Cervix. Ultrasound in Obstetrics & Gynecology, 12, 318-322.

[16]   Althuisius, S.M. and Dekker, G.A. (2004) Controversies Regarding Cervical Incompetence, Short Cervix, and the Need for Cerclage. Clinics in Perinatology, 31, 695-720.

[17]   Groom, K.M., Shennan, A.H. and Bennett, P.R. (2002) Ultrasound-Indicated Cervical Cerclage: Outcome Depends on Preoperative Cervical Length and, Presence of Visible Membranes at Time of Cerclage. American Journal of Obstetrics & Gynecology, 187, 445-449.

[18]   Ikimalo, J.I., Izuchukwu, K.E. and Inimgba, N. (2012) Pregnancy Outcome after Cerclage for Cervical Incompetence at the University of Port Harcourt Teaching Hospital, Port Harcourt. African Journal of Reproductive Health, 16, 180-184.

[19]   Drakeley, A.J., Roberts, D. and Alfirevic, Z. (2004) Cervical Cerclage for Prevention of Preterm Delivery: Meta-Analysis of Randomized Control Trials. Obstetrics & Gynecology, 103, 584-585.

[20]   Romeo, R., Gonzalez, R., Sepulveda, W., et al. (1992) Infection and Labor. VIII. Microbial Invasion of the Amniotic Cavity in Patients with Suspected Cervical Incompetence: Prevalence and Clinical Significance. American Journal of Obstetrics & Gynecology, 167, 1086-1091.

[21]   Shane, P., Kornman, L.H., Bell, R.J. and Brennecke, S.P. (2004) Cervical Surveillance as an Alternative to Elective Cervical Cerclage for Pregnancy Management of Suspected Cervical Incompetence. The Australian & New Zealand Journal of Obstetrics & Gynecology, 44, 228-232.