Obstetrical outcomes of emergency compared with elective cervical cerclage

Abstract

Objective: To study obstetric outcomes of emergency cerclage compared with elective cerclage.Study design: Retrospective cohort study of pregnancy outcomes of patients who underwent cervical cerclage, performed according to ACOG guidelines, between January 2006 and December 2014. Patients who underwent emergency cerclage, due to cervical shortening or cervical dilation (emergency cerclage group) were compared with patients who underwent history-indicated cerclage (elective cerclage group). Emergency cerclage was not performed in patients with uterine contractions, vaginal bleeding, or signs of chorioamnionitis. Procedure-related complications were defined as rupture of membranes or chorioamnionitis occurring after cerclage placement and before 24 weeks of gestation.Results: Overall, 154 patients with elective cerclage and 47 patients with emergency cerclage were included. Mean gestational age at cerclage operation was 13.1 ± 1 and 20.2 ± 3 weeks, respectively. There were no differences between the emergency cerclage group and the elective cerclage group regarding mean gestational age at delivery (36.1 ± 3 versus 35.6 ± 3, respectively, p = 0.7), rate of deliveries beyond 34 weeks of gestation (81.81% versus 78.72%, respectively, p = 0.67), rate of deliveries beyond 37 weeks of gestation (64.93% versus 59.57%, respectively, p = 0.6), cesarean deliveries (33.11% versus 39.13%, p = 0.48, respectively), or birthweight (2848 versus 2862 grams, respectively, p = 0.9). Regarding procedure-related complications, there were no differences between the elective and the emergency cerclage groups in the rate of chorioamnionitis (1.29% versus 4.34%, respectively, p = 0.22), or ruptured membranes (1.29% versus 4.34%, respectively, p = 0.22).Conclusion: Pregnancy outcomes of emergency cerclage are comparable with those of elective cerclage.