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Factors affecting the prolongation of gestation after emergency cervical cerclage

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Author:
No author available
Journal Title:
Chinese Journal of Perinatal Medicine
Issue:
8
DOI:
10.3760/cma.j.cn113903-20231014-00261
Key Word:
紧急宫颈环扎术;延长孕周;影响因素;Emergency cervical cerclage;Prolongation of gestation;Influencing factors

Abstract: Objective:To investigate the factors that influence the prolongation of gestation following emergency cervical cerclage.Methods:This retrospective study included 88 singleton pregnant women who were diagnosed with cervical incompetence and underwent emergency cervical cerclage at 12-26 weeks of gestation in the Jiaxing Maternity and Child Health Care Hospital from January 1, 2019 to September 1, 2022. The participants who delivered after 28 gestational weeks were assigned to the success group ( n=77), while those who delivered or miscarried before 28 gestational weeks were assigned to the failure group ( n=11). Two independent sample t-test or Mann-Whitney U test was used for comparison between groups. The factors affecting the prolongation of gestation after the procedure were selected by univariate analysis and multiple regression equations. Results:The success rate (delivery rate≥28 weeks) was 87.5% (77/88). There were six women delivered at 28-31 +6 weeks of gestation (6/77, 7.8%), two at 32-33 +6 weeks of gestation (2/77, 2.6%), 16 at 34-36 +6 weeks of gestation (16/77, 20.8%), and 53 at 37 weeks of gestation or later (53/77, 68.8%). Multiple regression analysis indicated that three times of early pregnancy miscarriage ( β=-5.1, 95% CI: -9.5 to -0.7), five times of early pregnancy miscarriage ( β=-11.8, 95% CI: -22.1 to -1.6), had two live births ( β=-6.9, 95% CI: -12.9 to -0.9), gestational age at cerclage ( β=-0.6, 95% CI: -1.0 to -0.3), external cervical os dilation<15 mm ( β=-12.1, 95% CI: -22.5 to -1.8) and ≥15 mm before cerclage ( β=-11.0, 95% CI: -21.4 to -0.71) were factors affecting the prolongation of gestation after cerclage. After adjusting for maternal age and weight before emergency cervical cerclage, five times of early pregnancy miscarriage ( β=-18.1, 95% CI: -28.3 to -7.8), gestational age at cerclage ( β=-0.6, 95% CI: -1.0 to -0.3), and external cervical os dilation≥15 mm before cerclage ( β=-11.4, 95% CI:-21.2 to -1.6) remained the significant influencing factors (all P<0.05). Conclusion:The number of early pregnancy miscarriages, gestational age at cerclage, and the width of external cervical os dilation before cerclage≥15 mm are the factors that influence the prolongation of gestation after the emergency cervical cerclage procedure.

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