EFFECT OF RESCUE CERVICAL CERCLAGE IN PRETERM BIRTH
DOI:
https://doi.org/10.63075/5byrgc67Abstract
Background: Preterm birth was one of the common causes of neonatal morbidity and mortality all over the world with cervical insufficiency being one of the significant causes. Rescue cervical cerclage, which is administered when there has been clinical or ultrasound observation of cervical shortening or dilatation was also viewed as potentially adding salvageable gestation and resulting in better pregnancy outcomes. Purpose: The purpose of the study was to determine whether rescue cervical cerclage leads to the decrease in the risk of preterm birth and better perinatal outcomes in cases of diagnosed cervical insufficiency. Methods: It was a retrospective study that took place in Bilawal Medical College for Boys LUMHS Jamshoro between months of May 2024 and April 2025. Ninety pregnant women were diagnosed with cervical insufficiency following an already experienced duration of 16 weeks of pregnancy and eligibility to the inclusion criteria were recruited. The participants were treated with the help of rescue cervical cerclage by the McDonald technique. Information was extracted relative to gestational age at delivery, birth weight of the newborn, Apgar, and neonatal intensive care unit (NICU) readmission. Comparisons were made between outcomes of preterm births and the results of neonates with historical controls based on the institutional records using statistical analysis. Results: A dramatic increase in the length of pregnancy was referred to rescue cervical cerclage, with mean gestational age at delivery in historical controls of 28.4 + 2.1 weeks and in the intervention group of 34.6 + 2.8 weeks (p < 0.001). The percentage of born under 34 weeks of gestation was reduced in the cerclage group compared to that of the controls, 31.1 and 72.2, respectively. Birth weight in neonates having low birth weight or less than 2.5 kg had been reduced sharply as indicated by 68.9% of the cases given to 37.8%. The NICU admissions were also minimized by 64.4 to 28.9 and early neonatal demise was lesser in the cerclage group. Conclusion: Rescue cervical cerclage was seen to work by minimizing preterm birth and enhancing perinatal outcomes in a woman with cervical insufficiency. These results confirmed the effectiveness of timely rescue cerclage as a useful treatment to extend gestation period and to increase neonatal survival in high risk pregnancies.
Keywords: Rescue cervical cerclage, preterm birth, cervical insufficiency, McDonald technique, neonatal outcomes, pregnancy prolongation.
