title: [Emergency cervical cerclage during mid-trimester of pregnancy: Experience of Clermont-Ferrand].
abstract: OBJECTIVE
  The objective of this study was to identify factors associated with favourable perinatal outcome after emergency cervical cerclage during mid-trimester of pregnancy.
  
  
  METHODS
  This is a retrospective study of all cases who underwent emergency cervical cerclage between 16 to 28 weeks of gestation (WG) over a period of 16 years in a University Hospital.
  
  
  RESULTS
  Among the 32 cases, the postnatal survival rate (day 28) was 80%. Delivery occurred at a mean gestational age of 33.1 WG [18-41.3 WG] and after 37 WG in 39% of cases. The perinatal outcome was improved by absence of bleeding (P=0.01), unripened cervix (P=0.02), cervical dilatation below 2 cm (P=0.002), no protruding membranes (P=0.02) and more advanced gestational age at the procedure (P=0.005). When no uterine contraction and no maternal blood inflammation were observed at admission, an expectancy of 48 hours before the procedure did not improve significantly perinatal outcome (gestational age at birth and survival rate [P=0.1 and P=0.3 respectively]).
  
  
  CONCLUSIONS
  Perinatal outcome after emergency cerclage depends on cervical status and gestational age at procedure. It is not influenced by an expectancy of 48 hours before intervention for patients with no uterine contraction and no maternal blood inflammation at admission.
authors.affiliation: Pôle gynéco-obstétrique-reproduction humaine, CHU de Clermont-Ferrand, Hôtel-Dieu, boulevard Léon-Malfreyt, 63003 Clermont-Ferrand, France.
authors.forename: A
authors.initials: A
authors.lastname: Delabaere
authors.forename: L
authors.initials: L
authors.lastname: Velemir
authors.forename: S
authors.initials: S
authors.lastname: Ughetto
authors.forename: M
authors.initials: M
authors.lastname: Accoceberry
authors.forename: J
authors.initials: J
authors.lastname: Niro
authors.forename: F
authors.initials: F
authors.lastname: Vendittelli
authors.forename: H
authors.initials: H
authors.lastname: Laurichesse-Delmas
authors.forename: B
authors.initials: B
authors.lastname: Jacquetin
authors.forename: D
authors.initials: D
authors.lastname: Lemery
authors.forename: D
authors.initials: D
authors.lastname: Gallot
mesh_terms: D000293:Adolescent; D000328:Adult; D023802:Cerclage, Cervical; D020070:Cervical Ripening; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D004638:Emergency Treatment; D005260:Female; D005865:Gestational Age; D006801:Humans; D007747:Labor Stage, First; D054238:Perinatal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D002581:Uterine Cervical Incompetence / Q000601:surgery; D014590:Uterine Contraction; D055815:Young Adult