[Therapeutic assessment of emergency cerclage. Analysis of a cases series].

BACKGROUND

Cervical incompetence is the incapacity of cervix to retain a pregnancy until term or until feasibility of the fetus. Patients present cervical enlargement without pain or contractions, vaginal strange sensation and membranes protrusion through most minimum degrees of enlargement. The cervical incompetence management can be rest in bed or cerclage. The emergency cerclage is carried out in patients with enlargement > or = 2cm with or without membranes prolapsus.

OBJECTIVE

To evaluate the maternal and neonatal results of emergency cerclage with Espinosa-Flores modified technique in pregnancy from 13 to 28 weeks.

PATIENTS AND METHODS

This series of cases was carried out as observational and prospective study, all patients with emergency cerclage and pregnancy from 13 to 28 weeks with cervical incompetence were included, during period of January 2000 to December 2003, in Gynecology and Obstetric Hospital from Medical Center La Raza, IMSS. Variables of study were gestational age at moment of cerclage, pregnancy prolongation, and maternal and neonatal complications.

RESULTS

Ten patients were included, with age of 32.1 +/- 5.1 years. It was observed a mean prolongation of pregnancy 10 weeks after cerclage. The gestation was interrupted at 31.1 +/- 5.2 weeks. The most frequently complication was premature membranes rupture. Neonatal survival was 70%.

CONCLUSIONS

The placement of emergency cerclage continuous being a therapeutic procedure to improve neonatal prognostic. The shortest prolongations of pregnancy were found in patients with greater enlargement (> or = 3cm) and who had membranes protrusion.