Keywords
Cerclage
Prematurity
How to Cite
Copyright © | All rights reserved.
The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.
Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.
Total reproduction
It is expressly prohibited and must be authorized by the journal.
Abstract
Objective: To evaluate cervical cerclage as a modulator of gestational age at delivery. Methods: This was a historical cohort in which 93 pregnant women were studied, 43 with IIC and cerclad using the Mac Donald technique, and 50 pregnant women with low obstetric risk. The present study was approved by the Ethics and Research Committee of the Faculty of Medicine of Barbacena. Results: The average age of the patients was 29.40 + 7.1 and the average of pregnancies, deliveries and abortions were respectively 2.54 +1.91, 0.79 +1.22 and 0.77 + 1 ,2, however, when the groups were compared, it was identified that the pregnant women with the highest number of pregnancies (p<0.001), deliveries (p<0.001) and abortions (p<0.001) were those who had IIC. Cerclage was performed at a mean of 12.50 + 0.93 weeks, but the gestational age at delivery was lower when compared to low obstetric risk pregnant women (37.50 + 1.62 x 38.40 + 19.5; p=0.03). Conclusion: Although cerclage patients have a lower mean gestational age when compared to low-risk pregnant women, the mean gestational age is within the range of a full-term fetus, which demonstrates that cerclage positively modulates gestational age at delivery in pregnant women. with IIC.
References
ADEWOLE N, et al. A five-year survey of cervical cerclage at a Nigerian Tertiary Hospital. J Gynaecol Reprod Med, 2018; 2(1): 1-5.
ALVES APVD. Associação entre fatores genéticos e risco aumentado de prematuridade em pacientes com antecedente de incompetência cervical. Dissertação (Mestrado em Ciências) – Faculdade de Medicina da Universidade de São Paulo, São Paulo, 2016; 120 p.
BERGHELLA V, et al. Transvaginal cervical cerclage: evidence for perioperative management strategies. Am J Obstet Gynecol, 2013; 209(3): 181-192.
BOLLA D, et al. Laparoscopic Cerclage as a Treatment Option for Cervical Insufficiency. Geburtshilfe Frauenheilkd., 2015; 75(8): 833-838.
BROWN R, et al. Cervical Insufficiency and Cervical Cerclage, J Obstet Gynaecol Can, 2013; 35(12): 1115–1127.
BROWN R, et al. No. 373-Cervical Insufficiency and Cervical Cerclage. J Obstet Gynaecol Can., 2019; 41(2): 233-247.
CHEN R, et al. Pregnancy outcomes and factors affecting the clinical effects of cervical cerclage when used for different indications: a retrospective study of 326 cases. Taiwan J Obstet Gynecol, 2020; 59:(1): 28-33.
DIAS BAS, et al. Prematuridade recorrente: dados do estudo “Nascer no Brasil. Rev Saúde Pública, 2022; 56(7).
KHALIL A, et al. Maternal age and adverse pregnancy outcome: a cohort study. Ultrasound Obstet Gynecol., 2013; 42(6): 634-43.
GLUCK O, et al. Obstetrical outcomes of emergency compared with elective cervical cerclage. J Matern Fetal Neonatal Med., 2017; 30(14): 1650-1654.
GOMES ALFM, et al. Incompetência istmocervical: atualização, Rev. Med Minas Gerais, 2012; 22 (Supl 5): S67-S70.
GONÇALVES ZR e MONTEIRO DLM. Maternal complications in women with advanced maternal age. FEMINA, 2012; 40(5):275-279.
HE D e ZHAO D. Analysis of the Timing of Cervical Cerclage Treatment in Pregnant Women with Cervical Insufficiency, and the Effect on Pregnancy Outcome. Emerg Med Int., 2022; 8340009.
LEE KN, et al. History-indicated cerclagem: the association between previous preterm history and cerclagem outcome, Obstet Gynecol Sci; 2018; 61(1): 23-29.
LISONKOVA S, et al. Does advance maternal age confer a survival advantage to infants born at early gestation? BMC Pregnancy Childbirth, 2013; 8(13): 87.
MATTAR R. A cerclagem para prevenção da prematuridade: para quem indicar? Rev. Bras. Ginecol. Obstet., 2006; 28(3): 139-142.
MENG L, et al. Identification of risk factors for incident cervical insufficiency in nulliparous and parous women: a population-based case-control study. BMC Medicine, 2022; 20: 348.
MONTORI GM, et al. Advanced maternal age and adverse pregnancy outcomes: A cohort study. Taiwan J Obstet Gynecol., 2021; 60(1): 119-124.
RODRIGUES LC, et al. Caracterização da gravidez com insuficiência istmocervical. Revista B
ROMAN A, et. al. Physical examination–indicated cerclage in twin pregnancy: a randomized controlled trial. Am J Obstet Gynecol, 2020; 223(6): e1-e11.
ROZAS A e SAMPAIO NETO L. Incompetência Cervical. Rev Fac Ciênc Méd., 2003; 5(2): 1-9.
SHENNAN AH, et al. Royal College of Obstetricians, Gynaecologists. Cervical Cerclage: Green-top Guideline No. 75. BJOG, 2022; 129(7): 1178-1210.
SOARES NPD, et al. Incompetência istmo cervical: indicação e técnica da cerclagem de emergência. Revista de Patologia do Tocantins, 2020; 7(2): 34-7.
STETSON B, et al. Outcomes with cerclagem alone compared with cerclagem plus 17alpha-hydroxyprogesterone caproate. Obstet. Gynecol, 2016; 128(5): 983-988.
THAKUR M e MAHAJAN K. Cervical Incompetence. StatPearls [Internet], 2022.
VASUDEVA N, et al. Emergency versus Elective Cervical Cerclage: An Audit of Our First Two Years of Service. Biomed Res Int., 2018; 2018: 2065232.
WEKERE FCC, et al. Cervical incompetence: prevalence, socio-demographic and clinical characteristics in Rivers State University Teaching Hospital, Port Harcourt, South-South Nigeria. Yenagoa Medical Journal, 2020; 2(1): 127-34.
ZIMMERMMANN JB, et al. Gestação de alto risco: Do pré-natal ao puerpério. 2021; 880p.