EP08.01: Does cervical cerclage affect the rate of Caesarean section?

Abstract

Objectives: We sought to determine the relationship between cervical cerclage and delivery by Caesarean section in general and secondary due to cervical dystocia. Method: This is a retrospective cohort study of patients who were high risk for preterm birth and some of them underwent cervical cerclage and others did not, over a six year period (January 2006- December 2011) in settings of major tertiary referral center, King Faisal Specialist Hospital & Research Center, Saudi Arabia. Results: Our study included 144 women who underwent cerclage and 152 who had no cerclage. There was significant difference in the overall emergency Caesarean sections between the groups (RR 2.02, 95% CI: 1.33-3.07). Cervical dystocia as an indication for emergency Caesarean section was more prevalent in cerclage group (RR 3.08, 95% CI: 0.81-11.61). BMI has no significant impact on the rate of emergency Caesarean section for cervical dystocia in cerclage group. Primigravida women with cerclage had a significantly higher rate of emergency Caesarean section and these decrease as the number of pregnancies increase (p<0.05). Conclusions: In our study we found that women who underwent cervical cerclage had higher risk of emergency Caesarean section in general. We did not find positive correlation between cervical dystocia and cerclage. Low parity may play important factor in higher rate of caesarean section after cerclage. As the parity increases, the risk for surgical delivery decreases. BMI has no influence on caesarean section rate in pregnancies with cerclage. Whether cerclage indeed influence the rate of cervical dystocia should be further evaluated by larger studies.