Clinical evaluation of cervical cerclage applications

Aim: In this study, we aimed to present our experience in the management of these cases by examining the clinical and operative characteristics of patients who underwent cervical cerclage with the indication of cervical insufficiency in our clinic between 2008 and 2022. Materials and Methods: The files of patients who were diagnosed with cervical insufficiency and underwent cerclage in our clinic between 2008 and 2022 based on transvaginal or transabdominal USG, patient history or physical examination findings were scanned and the data of 154 cases were accessed. Retrospectively, patients' age, parity (nulliparous-multiparous), smoking, cerclage week, last week with cerclage, week of birth, reaching term-prophylactic cerclage status, post-cerclage complications were recorded from patient files and hospital automation systems. Patients were contacted by phone to obtain their stories and data. Patients whose full data could not be accessed were excluded from the study. SPSS (Statistical Package for the Social Sciences) 25.0 package program was used in the statistical analysis of the data. p<0.05 was considered significant. Results: Emergency cerclage was performed in 33 (21.4%) of our cases and elective cerclage was performed in 121 (78.6%). The average week of birth of the cases was found to be 33.9±4.9 weeks, the cerclage week was 13.9±2.8 weeks, and the average week of termination of pregnancy was 35.6±2.4 weeks. Complication findings were found in 25 (16.2%) of the patients. It was observed that the rates of smoking and drug use were high in patients with complications (p<0.05), and the rate of history of AS was low. The emergency admission rate was found to be higher in patients with complications (p<0.05). Post-cerclage PROM rate was high in patients with complications (p<0.05). Parity in patients with complications, p. It was determined that the averages of the last week, the week of birth and the week of termination of pregnancy were low (p<0.05), and the average of the cerclage week was high (p<0.05). IVF history was found to be higher in patients with complications (p<0.05). Result: As a result, the 14-year data of our hospital and the results of the cervical cerclage procedures were examined, and it was determined that the factors affecting the success and complications after cerclage were smoking, drug use and obesity, and were associated with an increase in the complication rates after cerclage. It has been observed that the development of complications is less in elective cerclage procedures. It is also a fact that many prospective randomized studies are needed to elucidate this issue. Keywords: Cervical Insufficiency, Cervical Cerclage, Preterm birth