Anesthetic management of prophylactic cervical cerclage: a retrospective multicenter cohort study

Objectives Cervical incompetence complicates approximately 1 in 500 pregnancies and is the most common cause of second-trimester spontaneous abortion and preterm labor. No prospective or large retrospective studies have compared regional and general anesthesia for cervical cerclage. Study design Fol...

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Bibliographic Details
Published in:Archives of gynecology and obstetrics 2015-03, Vol.291 (3), p.509-512
Main Authors: Ioscovich, Alexander, Popov, Alla, Gimelfarb, Yuri, Gozal, Yaacov, Orbach-Zinger, Sharon, Shapiro, Joel, Ginosar, Yehuda
Format: Article
Language:English
Subjects:
Adult
Anesthesia
Anesthesia, Conduction
Anesthesia, Obstetrical
Anesthesia, Spinal
Anesthetics - administration & dosage
Cerclage, Cervical
Cohort analysis
Cohort Studies
Endocrinology
Female
Gynecology
Human Genetics
Humans
Maternal-Fetal Medicine
Medicine
Medicine & Public Health
Narcotics
Obstetric Labor, Premature - prevention & control
Obstetrics/Perinatology/Midwifery
Pregnancy
Pregnancy Outcome
Premature birth
Retrospective Studies
Sutures
Uterine Cervical Incompetence - prevention & control
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Summary:Objectives Cervical incompetence complicates approximately 1 in 500 pregnancies and is the most common cause of second-trimester spontaneous abortion and preterm labor. No prospective or large retrospective studies have compared regional and general anesthesia for cervical cerclage. Study design Following IRB approval, we performed a retrospective study in the two main medical centers over an 8-year period to assess the association of anesthesia choice with anesthetic and obstetric outcomes. Anesthetic and perioperative details were retrospectively collected from fails of all patients undergoing cervical cerclage from 01/01/2005 until 31/12/2012. Details included demographic data, anesthetic technique, PACU data and perioperative complications. Results We identified 487 cases of cervical cerclage in 327 women during the study period. The most commonly used anesthetic technique was general anesthesia (GA) (402/487; 82.5 %) compared with regional anesthesia (RA) (85/487; 17.5 %). When GA was performed, facemask was the most commonly used technique (275/402; 68.4 %), followed by intravenous deep sedation (61/402; 15.2 %); LMA (51/402; 12.7 %) and tracheal intubation (13/402; 3.2 %). There were no significant differences in demographic characteristics between women receiving general and regional anesthesia. Average duration of suturing the cervix among the GA group was 9.8 ± 1.6 and 10.6 ± 2.1 min in the RA group ( p  
ISSN:0932-0067
1432-0711
DOI:10.1007/s00404-014-3391-5