Pregnancy Outcomes Following Cervical Cerclage: A Prospective Observational Study From A Tertiary Care Centre In Tamilnadu
Keywords:
Cervical insufficiency, Cervical cerclage, Preterm birth, Pregnancy outcome, Ultrasound-indicated cerclageAbstract
Background: Cervical insufficiency is a known contributor to mid-trimester pregnancy losses and preterm births. Cervical cerclage, introduced by Shirodkar and McDonald in the 1950s, remains a primary intervention to prolong gestation in women with structural cervical weakness. The success of cerclage depends on patient selection, timing, and the indication for its placement.
Objective: This study aimed to evaluate pregnancy outcomes following cervical cerclage in women presenting with various risk factors and indications. It assessed gestational age at delivery, rates of miscarriage, term and preterm delivery, neonatal birth weight, and Apgar scores.
Methods: A prospective observational study was conducted at Government Chengalpattu Medical College and Hospital between February 2023 and January 2024. Fifty pregnant women who underwent cervical cerclage between 12 and 32 weeks of gestation were included. The participants were categorized based on cerclage indication: history-indicated, ultrasound-indicated, and rescue. Outcome measures included delivery timing, neonatal weight, Apgar scores, and associated complications.
Results: Most participants were aged 26–30 years and multiparous. Ultrasound-indicated cerclage was the most common indication (50%), followed by rescue and history-indicated types. Term delivery was achieved in 68% of cases. Higher birth weight and favorable Apgar scores were observed in cases with early and appropriately indicated cerclage. Better outcomes were associated with multiparity, spontaneous conception, absence of comorbidities, and cerclage placement between 14–20 weeks.
Conclusion: Cervical cerclage, particularly when placed electively based on ultrasound or obstetric history, significantly improves pregnancy outcomes. Timely intervention and proper case selection are essential to optimize maternal and neonatal prognosis.
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