Comparison of therapeutic and prophylactic cervical cerclages and their results

INTRODUCTION: Depending on the patient's history, cerclage procedure is called prophylactic cerclage in cases where the cervix has not been dilated or effaced yet. It is called therapeutic cerclage when performed after effacement and dilatation have occurred. Although there is literature arguing that therapeutic cerclages will be reduced with the spread of prophylactic cerclages, and pregnancy will be carried to further weeks; there are also researchers who argue that due to prophylactic cerclages, pregnant women who may not actually need cerclage are intervened and unnecessary procedure-related morbidity increases. In this study, we examined all cerclage procedures and indications performed in our clinic in two years. We tried to contribute to the literature by evaluating the contribution, frequency, and success of prophylactic and therapeutic cerclage procedures.
METHODS: Hospital records of 160 patients who underwent prophylactic and therapeutic cerclages were reviewed retrospectively.
RESULTS: Birth weeks of patients with a cervical length below 25mm (therapeutic cerclages) were found to be significantly lower than those with a cervical length of 25mm or above (prophylactic cerclages) (p=0.001). Birth weight of the babies of mothers with a cervical length below 25mm was found to be significantly lower (p=0.004).
DISCUSSION AND CONCLUSION: The success and pregnancy outcomes in therapeutic cerclages are worse than prophylactic cerclages.