Elective cervical cerclage versus no treatment in women with the history of cervical insufficiency: retrospective analysis of pregnancy outcomes

Purpose of investigation: To evaluate the effectiveness of elective cervical cerclage (CC) on the pregnancy outcome of patients with cervical insufficiency. Material and Methods: A retrospective cohort study was conducted on women with an obstetric history of cervical insufficiency on whom CC was applied or not. The two groups were compared for the main measure outcomes of mean gestational age at delivery, birth weight, Apgar scores at five minutes, number of premature and preterm deliveries, rate of preterm premature rupture of membranes, incidence of neonatal death, and admission to the neonatal intensive care unit (NICU). Results: A total of 183 women were eligible for the final analysis in the CC group and 183 were taken as the control group. There were significant differences in terms of the mean gestational age at delivery (37 +/- 4.0 vs. 34 +/- 5 weeks, p = 0.001), the mean birth weight (3,000 +/- 870 vs. 2,200 +/- 860 grams, p = 0.001), the number of preterm deliveries (< 37 weeks) (40% vs. 63%, p = 0.001, OR: 0.4, 95% CI: 0.26-0.61) between CC and control groups, respectively. Median Apgar scores at five minutes were 9 in CC group and 8 in the control group (p = 0.001) and the percentages of admission to NICU were 14% in CC group and 34% in the control group (p = 0.001, OR: 0.30, 95% CI: 0.17-0.52). Conclusion: The placement of elective CC seemed to be effective in patients with a history of mid-trimester abortion or preterm delivery due to cervical insufficiency.