Abstract
The pregnancy outcome following emergency cervical cerclage for cervical dilatation is unclear. The case notes of pregnant women who underwent the procedure from January 1996 until December 2005 at Hull Royal Infirmary and Castle Hill Hospitals was analysed. This procedure prolonged pregnancy in all patients with the mean duration of 24 days. There were 10 live births and two still births. Among the 10 live births there were five neonatal deaths (perinatal mortality 583/1000). Neonatal outcome was universally poor if the initial cervical dilatation was more than 5 cm. All patients should be informed of the survival rates before undergoing this procedure.
Highlights
Silent dilation of the cervix is a common cause of second trimester pregnancy loss and an obstetric treatment dilemma
The aim of this study is to review the pregnancy outcome of women who underwent cervical cerclage for cervical dilatation in the second trimester of pregnancy at Hull Royal Infirmary and Castle hill Hospital
48 cases of cervical cerclage were carried out in the time period including 20 elective cervical cerclages performed between 14 weeks - 16 weeks and 28 emergency cervical cerclages performed between 16 weeks - 28 weeks
Summary
Silent dilation of the cervix is a common cause of second trimester pregnancy loss and an obstetric treatment dilemma. Cervical cerclage using Macdonald’s stitch is controversial with the risk of rupturing the membranes balanced against prolonging the pregnancy. The greater the dilation the less chance of success could be expected. There is little data on which to base this assumption.
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