Feto Maternal Outcome after Cervical Cerclage in a Tertiary Level Hospital, Bangladesh

Abstract

Background: Cervical incompetence poses significant challenges in obstetrics, often leading to preterm labor or pregnancy loss. Cervical cerclage is a surgical intervention aimed at reinforcing the cervix to prevent premature delivery. This study evaluates the fetomaternal outcomes of cervical cerclage in a tertiary hospital setting in Bangladesh. Objective: To assess the fetomaternal outcomes following cervical cerclage in patients with cervical incompetence at Rajshahi Medical College Hospital. Method: A cross-sectional descriptive study was conducted with a sample size of 21 patients, purposively selected from the Gynae ward of Rajshahi Medical College Hospital. Data were collected from January 1, 2017, to December 31, 2018. Cervical cerclage was performed using the McDonald purse string suture technique. Results: Out of the 21 patients who underwent cervical cerclage, 6 had undergone in vitro fertilization (IVF). The procedure resulted in a 70.58% term delivery rate, with 12 patients delivering via caesarean section. Preterm labor occurred in 23.52% of cases. The overall fetal salvage rate was 88.23%. Among the patients, 66.67% were aged 31-35 years, 71.42% were nulliparous, and 9.52% experienced bleeding complications. Notably, 66.67% had a history of mid-trimester losses, and 70.58% achieved term delivery. Neonatal outcomes included 2 neonatal deaths and 6 admissions to the Neonatal Intensive Care Unit (NICU). Conclusion: Cervical cerclage appears to be an effective treatment for managing cervical incompetence, including in IVF pregnancies, demonstrating a high rate of fetal salvage and a favorable term delivery rate