2020, Number 02
Gestational days gained with different cerclage techniques in patients with cervical incompetence
Ibarra-Fortes MA, Ortega-Martín del Campo E, Carrera-Lomas E, Stuht-López D, Stern-Colin NJ
Full text
Language: Spanish
References: 13
Page: 71-79
PDF size: 196.70 Kb.
ABSTRACT
Objective: To report the experience in the practice of cerclages with prophylactic and therapeutic indication in patients with single or multiple pregnancy, with cervical incompetence. In addition, report the days of pregnancy gained, compare surgical techniques and cerclages in single and multiple gestations.Materials and Methods: Retrospective, descriptive, comparative and crosssectional study carried out between January 2011 and January 2018. Inclusion criteria: patients who had a cerclage and the pregnancy ended in our unit. Study variables: age, BMI, pregnancies, abortions, days of gestation earned, days in which they were placed, weeks of gestation completed at the end of pregnancy, surgical time, medications (tocolytics and antibiotics), complications from the placement of the cerclage until the end of pregnancy. For the descriptive analysis the statistical package IBM SPSS (version 22) was used; the distribution was obtained with Student's t test, the Shapiro-Wilk normality test was applied and the variables with normal distribution were analyzed, comparatively, with ANOVA and those with abnormal distribution with the Kruskal-Wallis test.
Results: 37 cases were analyzed in which the placement of cerclage prolonged 116.14 ± 47.4 days gestation, with an average termination of pregnancy at 246.41 ± 26.54 days. The Shirodkar cerclage was superior: it extended gestation 134.69 days with the end of pregnancy at 36 ± 2 weeks.
Conclusions: In patients with cervical incompetence cerclages are an option to prolong pregnancy. The Shirodkar technique had higher safety margins until the end of pregnancy (more than 34 weeks). The behavior in multiple pregnancies is similar, so in case of cervical incompetence should be applied.
REFERENCES
Conde-Agudelo, et al. Vaginal Progesterone is as Effective as Cervical Cerclage to Prevent Preterm Birth in Women with a Singleton Gestation, Previous Spontaneous Preterm Birth and a Short Cervix: Updated Indirect Comparison Meta-Analysis. Am J Obstet Gynecol 2018; 219 (1): 10-25. doi: 10.1016/j.ajog.2018.03.028.