Prognosis of cervical cerclage operations at a tertiary hospital

Öz

Aim: This study aimed to evaluate the efficacy and outcomes of cervical cerclage treatment to prevent preterm labor in our hospital. Method: This retrospective study included 51 pregnant women who underwent cervical cerclage between April 2005 and August 2008 in Izmir Ege Obstetrics and Gynecology Training and Research Hospital. Demographic characteristics such as age, occupation, education, economic status, smoking, and alcohol use were recorded. The number of pregnancies and deliveries, number of miscarriages, number of recurrent preterm deliveries, number of second-trimester miscarriages, and history of threatened miscarriage during pregnancy were also analyzed. All 51 pregnant women included in the study underwent a McDonald-style cerclage operation. The pregnant women were divided into two groups according to delivery below and above 37 weeks of gestation. Cervical length, cerclage week, mode of delivery, and indications for cerclage were compared between the groups. Results: Of the 51 pregnant women in our study, 3 were twin pregnancies, 1 were triplet pregnancies, and 47 were singleton pregnancies. The mean age of all cases was 28.63±5.64 years. The number of second-trimester abortions was higher in the preterm group compared to the term group. The rate of cases with threatened miscarriage was 52.2% in the preterm group and 35.7% in the term group, which was statistically significant. The mean cerclage week was 18.52 in the preterm group and 15.32 in the term group, and the difference between the two groups was statistically significant. The mean gestational age at delivery was 28.43 weeks in the preterm group and 38.21 weeks in the term group (p<0.05). Conclusion: Cerclage performed due to short cervix and funneling based on cervical ultrasonographic measurements is more effective in reaching the term pregnancy.

Anahtar Kelimeler

• Preterm birth
• cervical cerclage
• cervical insufficiency

Üçüncü basamak bir hastanede servikal serklaj operasyonlarının prognozu

Öz

Amaç: Bu çalışmada amacımız hastanemizde preterm doğumu önlemek için yapılan servikal serklaj tedavisinin etkinliğini ve sonuçlarını değerlendirmektir. Yöntem: İzmir Ege Doğumevi ve Kadın Hastalıkları Eğitim ve Araştırma Hastanesi’nde Nisan 2005 -Ağustos 2008 tarihleri arasında servikal serklaj yapılmış 51 gebeyi içeren retrospektif bir çalışmadır. Hastaların yaş, meslek, eğitim, ekonomik durum, sigara ve alkol kullanımı gibi demografik özellikleri kaydedildi. Gebelik ve doğum sayısı, düşük sayısı, tekrarlayan erken doğum sayısı, 2. trimestir düşük sayısı, gebelikte düşük tehdidi öyküleri de incelendi. Çalışmaya alınan 51 gebenin hepsine Mcdonald tarzı serklaj operasyonu yapılmıştır. Gebeler çalışmada 37 hafta altı ve üstü doğum yapmalarına göre iki gruba ayrıldı. Servikal uzunluk, serklaj haftası, doğum şekli ve serklaj endikasyonlar gruplar arasında karşılaştırıldı. Bulgular: Çalışmamıza alınan 51 gebeden 3 tanesi ikiz gebelik, 1 tanesi üçüz gebelik ve 47 tanesi tekil gebelikti. Tüm olguların yaş ortalaması 28.63±5.64 idi. 2. trimestir düşük sayısı preterm grupta term gruba göre daha yüksek düzeyde saptandı. Preterm grupta gebelikte düşük tehdidi olan olgular %52.2 term grupta ise %35.7 oranında olup istatistiksel olarak anlamlı bulundu. Preterm gruptaki olguların serklaj haftası ortalama 18.52, term gruptaki olguların ise 15.32 olup iki grup arasındaki fark istatistiksel olarak anlamlı bulundu. Preterm olguların doğum haftası ortalama 28.43, term olguların ise 38.21 idi (p<0.05). Sonuç: Servikal ultrasonografik ölçümlere dayalı kısa serviks ve hunileşme nedeni ile yapılan serklajlarda ise miad gebelik dönemi ulaşmada daha etkindir.

Anahtar Kelimeler

• preterm doğum
• servikal serklaj
• servikal yetmezlik

Kaynakça

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