Cervical Cerclage For Cervical Incompetence: Indication, Complication And Pregnancy Outcome At Aminu Kano Teaching Hospital, Kano: A Five-year Review

Abstract

Background: Cervical cerclage has salvaged so many pregnancies complicated by cervical incompetence. Objective: This study was carried out to determine the indications and pregnancy outcomes after cervical cerclage insertion. Methodology: This was a five-year retrospective study carried out in the department of Obstetrics and Gynecology of the Aminu Kano Teaching Hospital, Kano. The study covered the period of 1st January 2013 to 31st December 2017. The case notes of women who had cervical cerclage insertion during this period were retrieved and information such as age, gravidity, parity, indication for the cerclage and outcome of the pregnancy were extracted. This was entered into a proforma and analyzed using the SPSS Version 23 Computer software. Results:The mean age of the patients was 31.7±5.3years. Cervical cerclage was inserted between 13 and 32 weeks of gestation with a mean gestational age at insertion of 15.6 ± 3.6weeks. Mc Donald procedure accounted for 98.6% and only 1.4% had Shirodkar procedure. Cervical cerclage was history indicated in 62(87.3%), emergency cerclage was 8(11.3%) and ultrasound indicated in 1 (1.4%) of the women. Following the procedure, 64(80.28%) of the women took the pregnancy to term, however, Equal numbers of pregnancies were complicated by both preterm delivery and miscarriage, 7 (9.85%). Only seven patients had complication and out of that 4(57.1%) had pelvic pain, 2(28.6) had liquor drainage and 1(14.3%) had vaginal bleeding. Conclusion:Cervical cerclage for cervical incompetence is majorly history indicated and most of the patients carried the pregnancies to term after cerclage insertion. The complication rate is low.