EMERGENCY CERVICAL CERCLAGE USING A METREURYNTER IN PATIENTS WITH BULGING MEMBRANES

Emergency cervical cerclage was performed in 26 women between 18 and 32 weeks of gestation who had fetal membranes bulging through a widely dilated cervix. A bulging bag was pushed into the uterine cavity by a new method, using a metreurynter. The average prolongation of pregnancy after the operation in the 26 women was 41 days (ranging from 2 to 115 days). All pregnancies resulted in the live birth of altogether 28 babies. The neonatal survival rates at gestational ages of less-than-or-equal-to 26 (including two sets of twins), 27-29, and greater-than-or-equal-to 30 weeks at the time of cervical cerclage were 80.0 (12/15), 85.7 (6/7), and 100% (6/6), respectively. Ten (83.3%) of the 12 infants who survived from patients receiving cerclage at a gestational age of less-than-or-equal-to 26 weeks are alive and well. The average duration of pregnancy after cerclage was 60 days when cervical dilation was less-than-or-equal-to 5 cm at operation, in contrast to 5.4 days in patients with cervical dilation of greater-than-or-equal-to 6 cm, suggesting that emergency cervical cerclage could be suitable in the presence of a cervical dilation of 5 cm or less.