For Cervical Insufficiency, Cerclage Better Than Bed Rest

It reduces preterm delivery and results in more live births

WEDNESDAY, Feb. 8 (HealthDay News) -- In cases of dilated cervix and protruding fetal membranes, emergency cerclage is a safe and effective way to reduce preterm deliveries and improve outcomes, according to a study in the February issue of Obstetrics & Gynecology.

George Daskalakis, M.D., Ph.D., of the University of Athens, Greece, and colleagues studied 29 women with cervical dilatation and bulging membranes between 18 and 26 weeks of pregnancy who consented to cerclage. Another 17 women who refused cerclage were assigned to bed rest.

Those who underwent cerclage had significantly better outcomes than the bed rest group. Pregnancy was prolonged for a mean of 8.8 weeks in the cerclage group compared with 3.1 weeks for the bed rest group. Only 31 percent of the cerclage group had a preterm delivery of less than 32 weeks versus 94.1 percent of the bed rest group, with a mean birth weight of 2,101 grams versus 739 g, respectively. Of the cerclage group, 25 of 29 had live births, compared to only 7 of 17 in the bed rest group, and while 96 percent of the cerclage group neonates survived, the rate was only 57.1 percent for the bed rest group.

"We believe that in cases in which cervical dilatation is mainly related to mechanical failure, emergency cerclage should be considered the first option procedure," the authors conclude.

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