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Zakkia Khan, Radhia Khan and Anwar Khan Wazir
Objective: To determine the success rate of cervical cerclage in preventing preterm deliveries in patients having cervical incompetence.
Study design: Descriptive (cross sectional) hospital based study.
Place and duration of study: Department of obstetrics and Gynecology, Khyber Teaching Hospital Peshawar. One year from 1st January 2013 to 1st January 2014.
Methodology: Seventy five subjects were selected by consecutive (non-probability) sampling technique. The sample size was calculated by keeping success rate of cervical cerclage as 73.3%, confidence level of 95% and precision of 10%. All the patients were having a history of two or more recurrent midtrimester abortions or preterm deliveries and were subjected to cervical cerclage (McDonald suture). Age, gravidity, parity of the patients, gestational age at delivery, weight of the baby and apgar score was determined. Success rate of cervical cerclage was calculated.
Results: The average age, Gravida and para of the patients were 28.35± 3.96, 5.33±2.36 and was 1.7±1.46 respectively. Results were evaluated on the basis of pregnancy prolongation. Most of them (69%) delivered at term (>37 weeks), 17.3% had preterm deliveries (28-37weeks) and 17.3% had abortions (12-28weeks). Sixty four percent of babies had birth weight of 2.5kg or more and 36.0% had birth weight of less than 2.5kg. Fetal survival rate (good apgar score) was 76%. Overall success rate of cervical cerclage was 80%.
Conclusion: Application of cervical cerclage in pregnant women with previous preterm delivery reduces the preterm delivery rate at a reasonable cost with no additional risk to the mother and the fetus.