Patients which have been performed in our clinic retrospective evaluation

Objective: In this study, our aim is to evaluate the results of cervical cerclage patients applied in our clinic and to reveal the effect of cerclage procedure on obstetric outcomes. Material and Methods: For data of cases who underwent cerclage with the diagnosis of cervical insufficiency between 01.01.2013 and 01.01.2023 in our clinic, retrospectively patient files, electronic database and inaccessible information were collected by telephone interviews with patients. Single or multiple pregnancies with a pregnancy between 12 weeks and 25 weeks were included in the study. Cases with fetal anomaly incompatible with life, comorbidities such as preeclampsia that may pose a risk of maternal preterm birth, and cases with a cervical opening greater than 4 cm during the procedure were not included in the study. The data of sixty-six cases were found to be suitable for the study criteria. Demographic data, obstetric histories, current pregnancy data and current pregnancy outcomes were recorded. When the cerclage decision was taken, the gestational week, cervix length, dilatation and effacement, drugs used before and after cerclage, cerclage technique used, suture material, complications developed during and after the procedure, length of hospital stay, birth week, delivery type, birth weights of the babies were evaluated. SPSS 27.0 program was used in the analysis. P < 0.05 and p < 0.01 values were considered significant. Results: In our study, the week of birth of pregnant women who underwent cerclage; before <24 weeks in 9 patients (13.6%), between ≥24 - <34 weeks in 14 patients (21.2%), between ≥34 - <37 weeks in 14 patients (22.6%), in 28 patients (42.6%), it was observed that it occurred at ≥37 weeks. It was observed that 15 babies (22.7%) were born < 1500 g, 10 babies (15.2%) weighed between 1500-2500 gr, and 41 babies (62.1%) were born ≥ 2500 grams. Negative correlation was observed between cerclage week and birth weight, and this difference was statistically significant (p < 0.01). When the gestational week and the delivery week are compared during the cerclage application; it was observed that the week of delivery increased as the week of cerclage application decreased. Negative correlation was observed between cerclage week and delivery week, and this difference was statistically significant (p < 0.05). A negative correlation was observed between the cerclage week and the birth APGAR scores of the babies, and a statistically significant increase was observed in the APGAR scores of the fetuses of the pregnant women who had cerclage in the early weeks (p < 0.01). There was no statistically significant difference in BMI, age of the patient, history of gravida parity abortion and previous cesarean section, cerclage history in terms of gestational week and perinatal outcomes in patients who underwent cerclage (p > 0.05). It was observed that pregnancies ended earlier in the cerclage operation performed on patients with a high cervical dilation rate and a short cervical length (p < 0.01). Conclusion: In our study, we determined that cerclage applications reduce preterm births and prolong the gestation period. We determined that the time gained with cerclage has a positive statistical contribution to perinatal outcomes. We think that our study on cerclage applications and perinatal outcomes, which has limited data will contribute to the literature. Cases to be treated with cerclage should be selected supported by clinical findings when appropriate conditions are met and cerclage applications should be limited to well-chosen cases with a good anamnesis especially in cases where there is no other treatment option. Keywords: Pregnancy, Cervical Cerclage, Cervical Insuffiency, Preterm delivery