EFFICACY OF CERVICAL CERCLAGE USING MCDONALD’S TECHNIQUE IN PREVENTING PRETERM BIRTHS

Cervical Cerclage

Abstract

Objective: To study the efficacy of cervical cerclage using McDonald’s technique in prevention of preterm deliveries.
Study Design: Quasi- experimental study.
Place and Duration: September 2008 to January, 2010 in CMH Mardan.
Material and Method: Patients with singleton pregnancy having a history of one or more second trimester losses were selected on the basis of history, physical examination and ultrasound assessment of cervical length with a cut off of 2.5cm. Patients in advanced labor, fetal anomalies, polyhydramnios, or chorioamnionitis were excluded. Cervical cerclage using the McDonald’s technique was applied at 14 – 22 weeks of gestation under general anesthesia and later removed after 37 completed weeks or when the patient went into labor.
Results: A total of 52 patients were included. The rate of term deliveries was 80.77% while preterm were 19.23%. The live baby rate was 96.15% with a neonatal morbidity of 3.85%. The average prolongation in the gestation was 20.34 weeks. Most of the patients delivered normally with minimal rate of complications.
Conclusion: The use of cervical cerclage in patients with short cervices as assessed by examination and ulrasound scan is effective in preventing preterm births and prolonging gestations.