PREOPERATIVE PREDICTIVE FACTORS IN CERVICAL CER-CLAGE:OUR EXPERIENCE

Background: Preterm labour and mid-trimester abortions are very common problems and one of the common reasons considered is cervical incompetence. Cervical cerclage is the modality of treatment for cervical incompetence apart from progesterone supplementation though both were associated with occasional poor outcomes. Cervical cerclage is being discussed here. Objective: To determine poor prognostic factors for cervical cerclage and when to apply cervical cerclage on the basis of cervical length. Materials and methods: This is a retrospective study done in the Department of Reproductive Medicine Bansal hospital Bhopal. We studied all Shirodkar cerclage procedure done in our department from May 2015 to December 2020. A total of 49 patients were included in the study with whom the delivery outcome was available. Results: Emergency cerclage had the highest failure rate - 7 out of 8 patients delivered before the period of viability. Cervical cerclage was done in 14 twin pregnancies out of which six aborted. In six aborted twins, three had emergency cerclage. So twin gestation is second risk factor for failure. All primigravida patients with cervical length between 20-25 mm had delivery at term. Patients with cervical length below 20 mm had delivery before 36 weeks. Conclusion: We have found that two worst prognostic factors for the success of cerclage are emergency cerclage and twin gestation. We had not found any benefit of cerclage in primigravi-da patients with a cervical length above 20 mm. Although being a small retrospective study it is difficult to draw a conclusion. Keywords: Shirodkar cerclage; Mid trimester abortion; Cervical length; Emergency cerclage; Twin gestation