ISSN :2822-5872
Cervical Cerclage: An Obstetrical Dilemma [ACH Medical Journal]
ACH Medical Journal. 2024; 3(2): 65-71 | DOI: 10.5505/achmedj.2024.33042

Cervical Cerclage: An Obstetrical Dilemma

Atakan Tanacan1, Mehmet Sinan Beksac2
1Perinatology Clinic, Department of Obstetrics and Gynecology,University of Health Sciences, Turkish Ministry of Health Ankara Bilkent City Hospital, Ankara, Turkiye
2Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Türkiye, Division of Perinatology, Department of Obstetrics and Gynecology, Liv Hospital, Ankara, Turkiye

INTRODUCTION: This retrospective study evaluated women in whom transvaginal cervical cerclage (TCC) was performed in a previous pregnancy but delivered without cervical intervention in the most recent pregnancy. The primary aim was to underline the importance of etiology based management protocols on favorable pregnancy outcomes in patients with a history of TCC.
METHODS: We retrospectively evaluated 34 patients with at least one failed TCC for the treatment of cervical insufficiency (CI) but who gave birth without TCC in their most recent pregnancies.
RESULTS: All patients were evaluated preconceptionally and examined for maternal risk factors. At least one risk factor was present in all cases. The autoimmune antibody positivity rate was 41.2%. Twelve patients had Hashimoto thyroiditis, two had systemic lupus erythematosus, two had pernicious anemia, and two had anti-phospholipid antibody syndrome. 32 had homozygous or heterozygous methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms, while 11 were homozygous or heterozygous for factor 5 Leiden or prothrombin-20210A gene mutations.
DISCUSSION AND CONCLUSION: The elimination and management of risk factors for cervical ripening and dilatation are important for preventing unnecessary cervical interventions.

Keywords: Cervical insufficiency, Cervical cerclage, early pregnancy loss, Autoimmune disorders, Thrombotic events, Placental inflammation

Atakan Tanacan, Mehmet Sinan Beksac. Cervical Cerclage: An Obstetrical Dilemma. ACH Medical Journal. 2024; 3(2): 65-71

Corresponding Author: Atakan Tanacan, Türkiye
Manuscript Language: English