Outcome of pregnancy with history-indicated cervical cerclage insertion in a low-resource setting

Objective: History-indicated cervical cerclage insertion is required when factors in a woman's history could predispose to spontaneous miscarriage or preterm birth. This retrospective study determined the pregnancy outcome after insertion of history-indicated cervical cerclage for at least one previous mid-trimester spontaneous abortion over a 10-year period in a low-resource setting. Methods: This was a retrospective analysis of hospital data. Data was retrieved on biosocial and obstetrics parameters and analysed. The outcome measures were recurrence of spontaneous miscarriage, preterm delivery rate and fetal salvage rate. Descriptive frequencies were used to present results. The test of statistical significance was with Yates' coefficient correlation at 95% confidence interval. Results: Cervical cerclage rate was 7 per 1000 births. Diagnosis was clinical and cerclage was inserted at a mean gestational age of 15 +/- 3.6 weeks. Hospital admission greater than five days after cerclage insertion had no statistically significant difference on preterm delivery (CI 95%; p value = 0.98). Repeat spontaneous miscarriage occurred less (5.6%) after cerclage insertion, fetal salvage rate was 75% and the preterm birth rate was 30%. Conclusion: The limitations of the study notwithstanding, use of history-indicated cervical cerclage in pregnancy resulted in better fetal salvage rate and reduced recurrence of spontaneous miscarriage.