Application of cervical cerclage in intervention preterm birth

Objective To analyze the effect of cervical cerclage on prevention or treatment of preterm delivery.To explore the optimal timing of a cervical cerclage procedure.Methods A total of 81 women with spontaneous preterm labor(sPTL) and 51 with cervical incompetence(CI) before their 34th gestational weeks were enrolled in this study from January 2003 to March 2006.Patients with sPTL were treated with combination of emergent cervical cerclage and tocolytic,or the sole use of tocolytic.Patients with CI were treated with preventive cervical cerclage,emergent cervical cerclage,or non-cervical cerclage treatment,while some combined with magnesium sulfate tocolytic.Results Patients with sPTL treated with combination of emergent cervical cerclage and magnesium sulfate prolonged gestation by 45 days in mean compared to 1 d(0.75~16 d) in magnesium sulfate group,and obtained delivery rate at 66.7%(26/39) after 34th week and 30.8%(12/39) after 37th week..The CI patients received cervical cerclage for both prevention and treatment increased their chances of giving birth after the 32nd and 34th week(P0.05),while therapeutic cerclage lowered the rates of premature birth(P=0.02).Conclusions For treatment,the combination of cervical cerclage and magnesium sulfate can prevent preterm delivery.Although prophylactic cerclage does not show to decrease premature birth,it is recommended to prolong pregnancy until the 32nd and 34th week.Therapeutic cervical cerclage can also decrease the chances of premature birth.