Cervical funneling after cerclage in cervical incompetence as a predictor of pregnancy outcome

Objectives. To evaluate whether cervical funneling influences pregnancy outcome in women with short cervical length (CL) after cerclage, and to identify funneling parameters associated with pregnancy outcome. Methods. Medical records of women identified to have a short CL with or without funneling after cerclage were reviewed. Women with short CL as well as funneling were defined as cases (Funneling group), and those with short CL but no funneling were the controls (No Funneling group). We compared perinatal outcome between the two groups and analyzed the relationships between funneling parameters and pregnancy outcome. Results. Seventy-two patients were included in this study; 39 women with short CL and funneling and 33 with short CL and no funneling. The mean gestational age at delivery of the Funneling group was 33.7 weeks, as compared to 36.5 weeks for the No Funneling group (p < 0.001). We found a significant inverse association of funneling depth as well as volume with pregnancy outcome (p < 0.001, and p=0.005, respectively). However, funneling width was not associated with pregnancy outcome (p=0.49). Conclusions. Funneling depth and volume may be useful predictors of pregnancy outcome after cerclage.