Pregnancy complications and outcome following cervical cerclage operations at the University of Maiduguri Teaching Hospital

Abstract

Objective: To determine the Pregnancy Complications and Outcome following Cervical Cerclage Operations. Subject: The case records of 76 patients who underwent Cervical Cerclage Operation for Cervical incompetent at the University of Maiduguri Teaching Hospital between January, 1983 and December 1999 inclusive were reviewed. In all the patients the diagnosis of Cervical incompetence was made based on the history of two or more midtrimester abortions or preterm deliveries and ultra-sound finding of internal OS diameter of 16mm or more in the second trimester of Pregnancy. Result: The MacDonald (81%) and shirodkar (19%) techniques were the two forms of Cerclage employed. Preterm rupture of membranes vulvovaginitis and Urinary tract infection were the Common Post-insertion Complications encountered while antepartum haemorrhage, Perineal/Cervical tear and mal-presentations were the common associated labour complications. 65.3% of the deliveries were term births while preterm deliveries made up 23.1% of the births. The overall foetal salvage rate was 85.3%. There was no maternal death. The Peritanal mortality was 84 per 1000. Conclusion: The overall foetal salvage rate of 88.3% observed in this study is high and in a developing Country like Nigeria with inadequate neonatal facilities and a slim foetal survival between 24-28 weeks, any procedure like cervical cerclage that will prolong pregnancy until foetal maturity is still relevant and beneficial. KEY WORDS: Cervical incompetence, Cervical Cerclage, Pregnancy outcome, Maiduguri, Nigeria. [Nig J Clinical Practice Vol.5(1) 2002: 25-28]