Emergency cervical cerclage and pregnancy outcomes; a prospective clinical trial

Cervical incompetence is an important contributor to preterm birth and second trimester pregnancy loss.The aim of this study was to evaluate the effectiveness and safety of emergency cervical cerclage in women with advanced cervical dilatation and bulging of fetal membranes. The study included 363 women who underwent emergency cervical cerclage because of cervix dilatation and protruding membranes in mid-trimester at Prince Meshari Bin Saud General Hospital in Baljurashi, Al-Baha area, Saudi Arabia. Pregnancy outcomes were analyzed, and revealed that the placement of emergency cerclage led to the delivery of live infants with a success rate of 84.49%. The mean interval between cerclage and delivery was 92.16±26.62 days, with a mean gestation at delivery of 35.3±4.7 weeks and a mean birth weight of 2134.69±370.37 g. No severe maternal complications such as maternal death, hematosepsis, and hysterorrhexis occurred after the operation. There were significant correlations between the pregnancy outcome and risk factors, including any presenting symptoms, cervical dilatation and post-operative white blood cell count. Emergency cervical cerclage is effective in prolonging pregnancy and improving neonatal outcome in women with cervical incompetence. It should be considered a viable option for women with a dilated cervix in mid-trimester.