Croatian Society of Gynaecology and Obstetrics, and Croatian Society of Perinatal Medicine of Croatian Medical Association
Abstract
Cilj rada. Ustanoviti indikacije, nužnost i učinkovitost primjene serklaže cerviksa. Metode. Retrospektivnom studijom je u Županijskoj bolnici Livno obrađeno 756 trudnica sa serklažom cerviksa u razdoblju od 1986. do 2002. godine. Analizirani su: dob trudnice, gestacijska dob primjene serklaže, trajanje trudnoće poslije zahvata te broj trudnoća dovršenih prije navršenog 37. tjedna trudnoće. Trudnice su podijeljene prema indikacijama za serklažu u tri skupine. Prvu je skupinu činilo 68 ispitanica u kojih je anamneza opterećena pobačajem ili preranim porodom u prethodnoj trudnoći, u drugoj skupini 125 s palpacijskim nalazom dilatacije unutarnjeg ušća cerviksa, a u trećoj skupini su 563 trudnice kojima je indiciran postupak iz drugih razloga. Rezultati. U 19% trudnica s anamnezom pobačaja u drugom trimestru ili preranog poroda trudnoća je završila prijevremeno, što je značajno više u odnosu na ostale skupine (p=0,017). Trudnice iz druge skupine nisu češće imale prijevremeno dovršene trudnoće u odnosu na trudnice sa zatvorenim unutarnjim ušćem cerviksa. Zaključak. Ovo ispitivanje pokazalo je kako je opravdana serklaža samo onim trudnicama kojima bi prijevremeni porod nastupio zbog urođene ili stečene anatomske slabosti fibromuskularnog prstena vrata maternice. Ostvarivi utjecaj na tijek trudnoće primjenom serklaže i mirovanja je vjerojatno manji od 1%.Aim of the study. To establish the indications, necessity and efficiency of the cerclage. Methods. In retrospective study at the county hospital Livno the 756 pregnant women who had undergone cervical cerclage from 1986 till the year 2002 were analyzed. The age of pregnant women, gestational age when the cerclage was performed, the lasting of pregnancy after the procedure, as well as the number of labors that occurred prior to 37 completed weeks of gestation were analyzed. Patients have been divided into three groups, according to the indications for the procedure. First group of patients, 68 of them, had history of abortion or preterm labor. In the second group there were 125 with a dilatation of internal os of the cervix, whereas in the third group of 563 pregnant women cervical cerclage was performed for other reasons. Results. In 19% of patients with history of abortion or preterm labor pregnancies finished in preterm labor, that is a statistically significant higher rate (p=0.017). In other groups there were no significant results. Conclusion. According to our results cervical cerclage is indicated in the cases of incompetent cervical os, either congenital or acquired. Before performing it, all laboratory and clinical tests, in order to exclude different reasons of cervical incompetence, should be done. Output of cervical cerclage on the outcome of pregnancy is probably less than 1%
