The role of cervical ultrasound screening in determining the timing of emergency cerclage.
The present study aimed to determine the outcome of emergency cerclage depending on clinical presentation. Retrospective analysis of non-elective cerclage divided by clinical presentation: (1) bulging membranes with symptoms (n =19); (2) bulging membranes without symptoms (n =13); (3) asymptomatic ultrasound indicated were cerclage (n =23). Data from Group 1 and Group 2 were analysed retrospectively for average prolongation of pregnancy and delivery before 32 weeks. Average prolongation of pregnancy (suture to delivery interval) was significantly shorter in the group with symptoms compared with the group without symptoms (43 vs 89, p <0.01). Delivery before 32 weeks was also significantly higher in the group with symptoms compared with the group without symptoms (79% vs 31%, p <0.05). Emergency and ultrasound indicated cerclage are best performed prior to symptoms. Women at high risk of pre-term birth may benefit from transvaginal ultrasound surveillance.
Department of Obstetrics and Gynaecology, St Thomas' Hospital, London, UK. tezcanberrin@hotmail.com
B
B
Tezcan
N
N
Hezelgrave
A
A
Shennan
D000022:Abortion, Spontaneous / Q000453:epidemiology; D023802:Cerclage, Cervical / Q000379:methods*; D002584:Cervix Uteri / Q000000981:diagnostic imaging*; D005321:Extraembryonic Membranes / Q000000981:diagnostic imaging; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000517:prevention & control; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D002581:Uterine Cervical Incompetence / Q000000981:diagnostic imaging* / Q000601:surgery*