[Emergency cerclage].
OBJECTIVE
To evaluate the maternal and fetal morbility as well as the odds and conditions of pregnancy when performing an emergency cerclage.


METHODS
We performed a transversal, prospective and descriptive study of all the patients to which an emergency cerclage was performed in the Instituto Nacional de Perinatología between January 1, 1995 and December 31, 1996 having all the inclusion criteria. At such time 261 cerclages were performed in our Institute upon unique pregnancies being only 22 considered as emergency cerclages. We performed studies of their obstetrics background, their incidental as per their age group, complications during the inclusion for the technique used as well as restitution of fetal membranes, complications before, during and after surgery: as well as the time elapsed as from the inclusion of the cerclage to birth and the data of the new born.


RESULTS
21 patients had previous pregnancies and only one of them was her first one; only 6 of their children were alive. The average age was 29.5 +/- 3.8 years and the gestational average age of the inclusion of the procedure was of 18 +/- 2.6 weeks, having a cervical dilatation of 2.5 cm +/- 0.9 cm. In 10 patients we had to restitute fetal membranes. The long extended average time between the colocation of the cerclage and labor was 66.8 days (more than 9 weeks) and the 86.4% of the resolution was via vaginal.


CONCLUSIONS
It was observed that with the inclusion of the urgency cerclage we were able to prolong gestation in around 66 days, in which the main indicator of the perinatal forecast was the presence of fetal membranes or if they were bulging through internal cervical os. In this type of patients there is a major risk of having preterm labor and infectious maternal morbility. Notwithstanding that we believe that it is not an ideal procedure, the urgency cerclage has a place in current obstetrics. Prior to performing this procedure, we will have to study the patient as well as to have an adequate neonatal service.
Simon Pereira
Luis A
LA
Lira Plascencia
Josefina
J
García Benítez
Carlos Quesnel
CQ
Rosas Priego
Paola Iturralde
PI
Villalba
Ivan
I
D000328:Adult; D023802:Cerclage, Cervical / Q000009:adverse effects; D003430:Cross-Sectional Studies; D004630:Emergencies; D005260:Female; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies