Practice of Cervical Cerclage at a University Teaching Hospital in Southern Nigeria

Abstract

Background: Although the aetiology of preterm deliveries is largely unknown, it is said to be multifactorial and cervical insufficiency has been implicated. Hence, cervical cerclage is a necessary and common prophylactic obstetric procedure for preventing prematurity and associated recurrent second trimester miscarriages. Objectives: To evaluate the pattern, indications, and fetal outcome of cervical cerclage. Methodology: This was a retrospective study of 50 women who had cervical cerclage insertion at the University of Port Harcourt Teaching Hospital between January 1, 2021, and December 31, 2022. Data was obtained from the ward registers, theatre records, and case notes of the women, and entered into a structured proforma. Data analysis was done with SPSS version 25, and results are presented as frequency tables and charts. Results: The mean age of the patients was 35 ± 2.07 years. The mean of number of previous miscarriages was 2.46 ± 2.07, 56.8% were multiparous and 50% had a previous manual vacuum aspiration. Majority 35 (70%) of the women had prophylactic cerclage, 10 (20%) had cerclage following in-vitro fertilization and embryo transfer pregnancy, while 5(10%) had rescue cerclage. Most 29 (58%) of the prophylactic cervical cerclage insertion were done between 11-15 weeks, with MacDonald technique being the most common technique practiced. Of these, only 18 (36%) carried the pregnancy up to 36 weeks of gestation. Conclusion: Many of cervical cerclage procedures were performed for prophylaxis and resulted in improved fetal outcomes in women who had previously experienced mid-trimester losses or preterm delivery.