title: Effectiveness of emergency cerclage in cervical insufficiency.
abstract: OBJECTIVE
  To assess the effectiveness of emergency cerclage versus conservative management in improving obstetric and neonatal outcomes in women with clinically evident cervical insufficiency.
  
  
  METHODS
  Retrospective cohort study conducted on all women with a single viable pregnancy diagnosed with cervical insufficiency between the 14th and 24th gestational week without pPROM, clinical chorioamnionitis, vaginal bleeding, treatment-resistant uterine contractions or life-incompatible fetal anomalies, from January 2009 to December 2014. Obstetric and neonatal outcomes were compared between women who underwent cerclage and those who refused, preferring a conservative therapy.
  
  
  RESULTS
  Eighteen women underwent emergency cerclage and 19 were managed with a conservative therapy. Mean gestational age at delivery, time from diagnosis to delivery and rate of term birth were significantly higher in the first cohort. Those variables show a linear inverse correlation with the degree of cervical dilatation, with better outcomes in patients who underwent cerclage with a dilatation lower than 5.0 cm. No difference in mode of delivery were found.
  
  
  CONCLUSIONS
  Emergency cerclage is a valid therapeutic option between the 14th and 24th gestational week in presence of cervical insufficiency when signs of premature labour or infection are not present, with lower expectations with a dilatation greater than 5 cm.
authors.affiliation: a Clinica Ostetrica E Ginecologica, Presidio Ospedaliero Di Alta Specializzazione "G. Salesi", Az. Ospedaliero-Universitaria Ospedali Riuniti Di Ancona, Università Politecnica Delle Marche , Ancona , Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ciavattini
authors.affiliation: a Clinica Ostetrica E Ginecologica, Presidio Ospedaliero Di Alta Specializzazione "G. Salesi", Az. Ospedaliero-Universitaria Ospedali Riuniti Di Ancona, Università Politecnica Delle Marche , Ancona , Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Delli Carpini
authors.affiliation: a Clinica Ostetrica E Ginecologica, Presidio Ospedaliero Di Alta Specializzazione "G. Salesi", Az. Ospedaliero-Universitaria Ospedali Riuniti Di Ancona, Università Politecnica Delle Marche , Ancona , Italy.
authors.forename: Virginia
authors.initials: V
authors.lastname: Boscarato
authors.affiliation: a Clinica Ostetrica E Ginecologica, Presidio Ospedaliero Di Alta Specializzazione "G. Salesi", Az. Ospedaliero-Universitaria Ospedali Riuniti Di Ancona, Università Politecnica Delle Marche , Ancona , Italy.
authors.forename: Tamara
authors.initials: T
authors.lastname: Febi
authors.affiliation: a Clinica Ostetrica E Ginecologica, Presidio Ospedaliero Di Alta Specializzazione "G. Salesi", Az. Ospedaliero-Universitaria Ospedali Riuniti Di Ancona, Università Politecnica Delle Marche , Ancona , Italy.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Di Giuseppe
authors.affiliation: a Clinica Ostetrica E Ginecologica, Presidio Ospedaliero Di Alta Specializzazione "G. Salesi", Az. Ospedaliero-Universitaria Ospedali Riuniti Di Ancona, Università Politecnica Delle Marche , Ancona , Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Landi
mesh_terms: D000328:Adult; D023802:Cerclage, Cervical / Q000379:methods*; D004630:Emergencies; D004638:Emergency Treatment; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000517:prevention & control; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000517:prevention & control; D012189:Retrospective Studies; D016896:Treatment Outcome; D002581:Uterine Cervical Incompetence / Q000601:surgery*
keywords: Cervical dilatation; cervical incompetence; cervical stitch; obstetric outcomes; preterm birth