Emergency cerclage: gestational and neonatal outcomes

• Main Authors: Maíra Marinho Freire Costa, Antonio Gomes de Amorim Filho, Mônica Fairbanks de Barros, Agatha Sacramento Rodrigues, Marcelo Zugaib, Rossana Pulcineli Vieira Francisco, Mário Henrique Burlacchini de Carvalho
• Format: Article
• Language: English
• Published: Associação Médica Brasileira
• Series: Revista da Associação Médica Brasileira
• Subjects: Cerclagem cervical; Emergências; Gravidez de alto risco; Nascimento prematuro; Incompetência do colo do útero
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302019000500598&lng=en&tlng=en

SUMMARY BACKGROUND: The gestational and neonatal outcomes of women with early cervical dilatation undergoing emergency cerclage were evaluated and compared with women treated with expectant management and bed rest. METHODS: Retrospective analysis of pregnant women admitted between 2001 and 2017 with a diagnosis of early cervical dilatation and/or bulging membranes. Patients with a singleton pregnancy of a fetus without malformations, between 16 and 25 weeks and 6 days, with cervical dilatation of 1 to 3 cm were included; patients who delivered or miscarried within 2 days after admission were excluded. RESULTS: The study enrolled 30 patients: 19 in the cerclage group and 11 in the rest group. There was a significant difference, with the cerclage group showing better results concerning gestational age at delivery (28.7 vs. 23.3 weeks; p=0.031) and latency between hospital admission and delivery (48.6 vs. 16 days; p=0.016). The fetal death rate was lower in the cerclage group (5.3% vs. 54.5%, p=0.004). Considering gestational age at delivery of live newborns, no difference was observed between the cerclage and rest groups (29.13 vs. 27.4 weeks; p=0.857). CONCLUSIONS: Emergency cerclage was associated with longer latency, a significant impact on gestational age at delivery and reduction in the fetal death rate.