INTRODUCTION- Cervical insufciency, earlier known as cervical incompetence, is the inability of the
cervix to maintain pregnancy till term due to structural or functional defects. Approximately 16.25% of
second-trimester pregnancy losses and 2% of premature deliveries are due to cervical incompetence.
OBJECTIVE- The purpose of this study was to compare the outcome of pregnancy in patients who underwent early (12-16
weeks) cervical cerclage along with oral progesterone supplementation versus those having remedied with high dose
intravaginal progesterone supplementation.
MATERIAL AND METHODst This retrospective study was conducted in a maternity hospital in Gwalior from 1 January 2018 to
th 30 June 2021.
Comprehensive history, thorough clinical examination, laboratory investigations, ultrasonography measurement of cervical
length, mode of delivery, gestational age at the time of delivery, neonatal outcome, NICU admission, and other parameters
were collected from the medical les. patients were divided into two groups.
Ÿ Group 1(N-49) – Those who were remedied with high-dose vaginal progesterone supplementation continued uptil 34 wks of
gestation.
Group 2 (N-49) – Those who underwent Mc Donald type of cervical encerclage at 12-16 weeks along with oral progesterone (10
mg Duphaston twice daily dose) supplementation continued up till 34 weeks of gestation.
RESULT- In our study, in the cervical cerclage group, only (4.1%) patients were delivered before 34 weeks while in the vaginal
progesterone group (18.4%) patients were delivered before 34 weeks.
In the cervical cerclage group (53.1%) patients were delivered between 34-37 weeks while in the vaginal progesterone group,
(44.9%) of the patient delivered between 34-37 weeks.
In the cervical cerclage group, the cesarean section rate was lower than only the vaginal progesterone group and admission to
NICU of babies was also less (22.4%) in this group in comparison to the vaginal progesterone only group (36.7%).
CONCLUSION- Our study showed that cervical cerclage plus oral progesterone supplementation in women with extremely
shortened cervix signicantly decreased overall spontaneous preterm birth rates, prolonged pregnancy latency, and
decreased the overall neonatal morbidity and mortality and is more effective than the vaginal progesterone group.
The association of chronic endometritis with mid-trimester loss due to cervical incompetence and the outcome of laparoscopic cervical cerclage
