Exam-indicated cerclage in patients with fetal membranes at or beyond external os: a retrospective evaluation.
OBJECTIVE
To evaluate pregnancy outcome in women with fetal membranes at or beyond external os who underwent exam-indicated cerclage or conservative management.


METHODS
Retrospective cohort study including 52 patients with fetal membranes at or beyond external os between 17 and 27 weeks of gestation, treated in two third-level hospitals, between January 2001 and April 2009. The outcomes of interest of the study, prolongation of pregnancy and neonatal survival rate, were stratified according to type of management, parity, clinical conditions and blood tests at admission and calculated using the Kaplan-Meier algorithm.


RESULTS
Of 52 women, 37 received exam-indicated cerclage and 15 were managed conservatively. The rate of patients still pregnant beyond 180 days within the cerclage group differed significantly from those of the conservative management group (80% vs 0%, respectively) (P-value<0.001). No difference has been found according to neonatal survival (82% versus 53%, respectively).


CONCLUSIONS
Exam-indicated cerclage appears to prolong gestation compared to expectant management.
Department of Obstetrics and Gynecology, St. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy.
Alessandra
A
Curti
Giuliana
G
Simonazzi
Antonio
A
Farina
Hilda
H
Mehmeti
Fabio
F
Facchinetti
Nicola
N
Rizzo
D000328:Adult; D023802:Cerclage, Cervical; D005321:Extraembryonic Membranes; D005260:Female; D006801:Humans; D007226:Infant Mortality; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011391:Prolapse; D012189:Retrospective Studies; D016896:Treatment Outcome; D002581:Uterine Cervical Incompetence / Q000601:surgery*