Evaluation of cervical cerclage for sonographically incompetent cervix in at high risk patients.
BACKGROUND
To determine the impact of Cervical Cerclage (CC) for prolongation of pregnancy, maternal and foetal outcome.


METHODS
This Descriptive cross-sectional study was conducted over a period of 2 years patients with history of two or more recurrent midtrimester abortions/preterm deliveries were included. Those with abnormal foetus, vaginal bleeding and choreoamneonitis were excluded. All patients were subjected to transvaginal sonography. Those having sonographic evidence of cervical shortening/dilatation/cone formation were subjected to McDonald suture. Age, parity, period of gestation and aetiological factors were determined.


RESULTS
Results were evaluated on the basis of pregnancy prolongation, 14-28 weeks (7.5%), 28-36 weeks (18.7%), 35-37 weeks (73.7%),vaginal delivery in (70%), instrumental (1305%), Caesarean section (17.5%),miscarriage (7.5%), prematurity (18.7%), term delivery (73.7%), prenatal death (13.7%), foetal survival rate (85.1%). No intraoperative complication found. During pregnancy premature rupture of membrane (3.7%), abruption (2.5%), severe pre-eclampsia (3.7%). During labour cervical dystocia was found in (2.5%), foetal distress (8.7%), mal-presentations (6.2%), cervical trauma (3.7%).


CONCLUSIONS
We determined a high success rate of cervical cerclage on properly selected patients with sonographic evidence of cervical changes. Cervical sonography can be a valuable adjunct to clinical evaluation of these patients.
Shamshad
Department of Gynaecology, Ayub Medical College, Abbottabad.
Mustajab
Yasmin
Y
Jehanzaib
Muhammad
M
D000328:Adult; D023802:Cerclage, Cervical; D002584:Cervix Uteri / Q000000981:diagnostic imaging / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D012008:Recurrence; D018570:Risk Assessment; D014463:Ultrasonography; D002581:Uterine Cervical Incompetence / Q000000981:diagnostic imaging / Q000601:surgery*