Effectiveness of Prophylactic Cervical Cerclage in Prolonging Higher-Order Multiple Pregnancies

• Published in: Sultan Qaboos University medical journal 2017-08, Vol.17 (3), p.314-318
• Main Authors: Obeidat , Nail, Sallout , Bahauddin, Hamadneh , Jehan, Khader , Yousef, Amarin , Zouhair, Obeidat , Maha, Hamadneh , Shereen, Alchalabi , Haifa
• Format: Article
• Language: English
• Subjects: Age; Cerclage, Cervical - methods; Cerclage, Cervical - statistics & numerical data; cervical cerclage; Cesarean Section - statistics & numerical data; Clinical & Basic Research; Embryos; Emergencies; Emergency medical care; Female; Fetuses; Gestational Age; GYNECOLOGIC DISEASES; Humans; JORDAN; Mortality; Multiple births; multiple pregnancies; OBSTETRICAL SURGERY; Obstetrics; PARTURITION INTERVAL; Patients; Pregnancy; Pregnancy, Multiple; Premature birth; Premature Birth - prevention & control; preterm births; Prevention; prophylactic surgical procedure; Retrospective Studies; SAUDI ARABIA; Sutures; Ultrasonic imaging; UTERUS; الأردن; الأمراض النسائية; الرحم; السعودية; جراحة التوليد; فترة الولادة
• ISSN: 2075-051X; 2075-0528
• DOI: 10.18295/squmj.2017.17.03.009

Objectives : This study aimed to assess the value of prophylactic cervical cerclage in prolonging higherorder multiple pregnancies. Methods : This retrospective study included all women with higher-order multiple pregnancies beyond 24 gestational weeks treated at the King Abdullah University Hospital in Irbid, Jordan, and King Fahad Medical City in Riyadh, Saudi Arabia, between February 2014 and January 2015. Selected maternal characteristics and obstetric outcomes were compared between women who received prophylactic cervical cerclage and those who did not. Results : A total of 146 women with higher-order multiple pregnancies were included in the study; of these, 94 (64.4 %) underwent a prophylactic cervical cerclage insertion procedure and 52 (35.6%) women did not. No significant difference was found between the two groups with regards to maternal age, parity or number of fetuses. However, the mean gestational age at delivery was significantly higher for women without compared to those with prophylactic cervical cerclage (32.9 weeks versus 31.7 weeks) according to both univariate and multivariate analyses (P = 0.013 and 0.046, respectively). Additionally, 40.4 % of women without and 14.9 % of women with prophylactic cervical cerclage gave birth after 34 gestational weeks (P = 0.003). Conclusion: Overall, prophylactic cervical cerclage was not associated with prolongation of the pregnancy among women with higherorder multiple pregnancies in the current study.