Mid-trimester cerclage outcomes in singleton and twin pregnancies: a single tertiary center experience

Abstract

Objective: The aim of this study was to evaluate the maternal and neonatal outcomes of patients who underwent ultrasonography (USG) and emergency-indicated cerclage in the mid-trimester in singleton and twin pregnancies. Methods: A total of 55 patients, 43 with singleton and 12 with twin pregnancies who underwent cerclage for short cervix (<25 mm) or cervical dilation between January 2015 and December 2021 were included in the study. The primary outcome was gestational age at birth, and secondary outcomes were neonatal birth weight, the status of admission to neonatal intensive care unit, neonatal survival, and the neonatal birth rates at <24 weeks, 24–27⁺⁶ weeks, 28–33⁺⁶ weeks, 34–36⁺⁶ weeks and >37 weeks. Results: In singleton pregnancies, delivery interval was 15.05 (±2.9) weeks in the USG indication group and 2.8 (±2.5) weeks in the emergency indication group (p<0.001). The rate of pregnant women in the USG indication group who gave birth between 24–27⁺⁶ weeks of gestation was 4.9% (n=2), and the rate of pregnant women in the emergency indication group was 55.6% (n=5) (p<0.001). In total, in singleton pregnancies the rate of take-home baby was 85.7%, and neonatal mortality was 14.3%. In twin pregnancies, delivery interval was 12±1.41 weeks in the USG indication group, and it was 1.8±0.83 weeks in the emergency indication group (p<0.003). In twin pregnancies, the take-home baby rate was 94% and neonatal mortality was 6%. Conclusion: Cervical cerclage reduces the possible risks of preterm delivery by prolonging the interval until delivery, especially in patients with singleton and twin pregnancies for whom USG is indicated, and promising neonatal outcomes are achieved.