Cervical cerclage for progressive cervical dilation in the second trimester of twin pregnancy

Abstract

ObjectiveTo evaluate the maternal and infant outcomes of different cerclage techniques for the patients with short cervix or obvious cervical dilation in the second trimester of twin pregnancy. MethodsWomen with twin pregnancies and cervical shortening or dilating in the second trimester of pregnancy were retrospectively selected, who were treated in the Second Hospital of Jilin University from January 2016 to February 2022. McDonald transvaginal cervical cerclage was conducted in 12 cases （group A） and conservative treatment was given in 21 cases （group B）. The clinical features and pregnancy outcomes were observed in two groups. ResultsThe extend gestational age in group A was significantly longer than that in group B ［（9.5±4.0） weeksvs（4.6±4.3） weeks, t=3.287, P＜0.01］. The incidence of premature rupture of membranes significantly increased in group A compared with group B （50.0%vs14.3%, P＜0.05）. Compared with those in group B, the risk of neonatal asphyxia was significantly reduced （4.2%vs38.1%, P＜0.01）, the neonatal survival rate increased （91.7%vs52.4%, P＜0.05）, and the delivery rate at less than 28 weeks decreased （16.7%vs57.1%, P＜0.05） in group A . Compared with 13 patients in group B, 7 patients in group A who used atoxiban in combination showed an increase in gestational age ［（9.1±3.7） weeksvs（4.1±4.8） weeks, P＜0.05］. ConclusionFor the patients with cervical length＜15mm or cervical dilation＞10mm in the second trimester of twin pregnancy, cervical cerclage can reduce the risk of neonatal asphyxia and improve neonatal survival rate. The gestational age can be prolonged with the combination of atoxiban and cervical cerclage.

Keywords

• cervical cerclage
• cervical incompetence
• pregnancy outcome
• premature birth
• uterine contraction inhibitor
• premature repture of membranes
• neonatal asphyxia
• twin pregnancies