International Journal of Infertility & Fetal Medicine

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VOLUME 4 , ISSUE 1 ( January-April, 2013 ) > List of Articles

RESEARCH ARTICLE

Can We reduce Fetal Loss with Second Trimester Miscarriages and very Preterm Births due to Cervical Incompetence in Women with Repeated Failed Vaginal Cerclages and/or Inaccessible Cervices?

Sirisha Rao Gundabattula, Lakshmi Rathna Marakani, Shashikala Dasari

Citation Information : Gundabattula SR, Marakani LR, Dasari S. Can We reduce Fetal Loss with Second Trimester Miscarriages and very Preterm Births due to Cervical Incompetence in Women with Repeated Failed Vaginal Cerclages and/or Inaccessible Cervices?. Int J Infertil Fetal Med 2013; 4 (1):1-5.

DOI: 10.5005/jp-journals-10016-1052

License: CC BY-NC 4.0

Published Online: 01-04-2013

Copyright Statement:  Copyright © 2013; The Author(s).


Abstract

Objective

To assess the reduction in fetal loss following transabdominal cervicoisthmic cerclage done for repeated failed vaginal cerclages and/or inaccessible cervices.

Study design

An observational study of 113 pregnancies in 90 women after transabdominal cervicoisthmic cerclage from January 1999 to December 2010 at Fernandez Hospital, Hyderabad, Andhra Pradesh, India.

Results

Mean gestational age at the time of elective transabdominal cervicoisthmic cerclage was 11.6 weeks. Patients were delivered by lower segment cesarean section (LSCS) with a mean gestational age of 36 weeks. Live birth rate was 90.5%. Incidence of mid-trimester miscarriages was 8.6% after cerclage compared with 62.9% before cerclage. Before cerclage, only 13.1% pregnancies continued beyond 28 weeks whereas after cerclage, 88.6% crossed the period of viability. Prior to cerclage, preterm delivery rate was 7.0% (as majority of the pregnancies were lost prior to period of clinical viability) and only 13.6% of these preterm babies survived. Although the incidence of preterm deliveries was 23.8% after cerclage, 80% of these preterm babies survived. Excluding first-trimester miscarriages, fetal loss was 93.3% prior to cerclage and 13.7% postcerclage. In effect, the take home baby rate among pregnancies was only 5.8% before cerclage compared with 86.7% after cerclage. Mean birth weight after cerclage was 2.5 kg.

Conclusion

Transabdominal cerclage reduces fetal loss and improves pregnancy outcome in women who had failed vaginal cerclages and in those with inaccessible cervices.

How to cite this article

Marakani LR, Dasari S, Gundabattula SR, Joseph E. Can We reduce Fetal Loss with Second Trimester Miscarriages and very Preterm Births due to Cervical Incompetence in Women with Repeated Failed Vaginal Cerclages and/or Inaccessible Cervices? Int J Infertility Fetal Med 2013;4(1):1-5.


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