Comparison of Perinatal Outcomes of Cervical Cerclage Procedures According to Indications, a Retrospective Cohort Study

Introduction: Cervical insufficiency and its complications of prematurity and fetal loss are still one of the major problems of obstetrics. Cerclage operation is an intervention with proven efficacy for the prevention of cervical insufficiency. The aim of this study was to compare the cerclage groups in terms of perinatal outcomes by forming homogeneous groups according to cerclage indication and duration of application and to develop new approaches for the prevention of prematurity and related complications in the light of the findings obtained. Method: This was a retrospective cohort study in a single center. A total of 61 patients who underwent cervical cerclage operation between January 2021 and August were divided into three homogeneous groups according to the indications and timing of surgery: The history-indicated cerclage group was performed in the early midtrimester between 12-18 weeks and the ultrasound-indicated and the physical examination-indicated cerclage groups were performed in the late midtrimester between 18-27+6 weeks and these three groups were compared in terms of perinatal outcomes. Results: As a result of our study, although adverse perinatal outcomes were observed more frequently as we progressed from the history-indicated cerclage group to the ultrasound-indicated and then to the physical examination-indicated cerclage groups, perinatal outcomes were statistically similar for all three groups. Conclusion: Ultrasound and physical examination-indicated cerclages performed in the late midtrimester are efforts to prevent cervical insufficiency and its complications of pregnancy loss and prematurity, and in selected cases have the similar perinatal outcomes as history-indicated cerclage performed in the early midtrimester.