Evaluation of the Impact of Second Trimester Cervical Cerclage on Perinatal Outcomes: The Experience of a Single Tertiary Centre

Abstract

Objectives: The aim of this study is to evaluate the results of patients who underwent cervical cerclage and the contribution of this procedure to the continuation of pregnancy.
 Materials and Methods: The records of patients who underwent cervical cerclage with McDonald method in the perinatology clinic of Başakşehir Çam ve Sakura City Hospital between October 2021 and September 2022 were evaluated retrospectively. The study included 58 cases diagnosed with cervical insufficiency in which cerclage was performed between the 14th and 25th weeks of pregnancy. According to the cerclage indication, patients were divided in two groups as elective cerclage (with history indication) and emergency cerclage (with physical examination and ultrasonography indication). Demographic characteristics, pregnancy and neonatal outcomes of the cases were recorded.
 Results: Out of the 58 cases included in the study, 57 of them were singleton pregnancies, and one was a twin pregnancy. The patients' mean age was 29.7±5.3 years. The elective cerclage group consisted of 23 cases and the emergency cerclage group consisted of 35 cases. Among the patients applied cerclage, 8 (15.1%) delivered before 24 weeks, 5 (9.4%) delivered between 25-28 weeks, 3 (5.7%) delivered between 29-32 weeks, 10 (18.9%) delivered between 33-36 weeks, and 27 (50.9%) delivered at 37 weeks or later. Elective cerclage patients had a lower mean gestational age (15.6±2.5 weeks) compared to emergency cerclage patients (20.9±2.7 weeks), and the interval for elective cerclage (17.1±7.5 weeks) was statistically longer than that for emergency cerclage (12.6±6.9 weeks) (p: 0.031).
 Conclusion: In our study, it has been observed that both elective and emergency cerclage in patients with cervical insufficiency extend the duration of pregnancy, and reduce the incidence of second-trimester loss and preterm birth.