title: Evaluation of cervical cerclage for sonographically incompetent cervix in at high risk patients.
abstract: 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.
authors.affiliation: Department of Gynaecology, Ayub Medical College, Abbottabad.
authors.lastname: Shamshad
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Mustajab
authors.forename: Muhammad
authors.initials: M
authors.lastname: Jehanzaib
mesh_terms: 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*