Emergency cerclage in the presence of protruding membranes: is pregnancy outcome predictable?

Background. The aim of this retrospective study is to verify whether some m aternal features are related to pregnancy outcome in cases of emergency mid -trimester cerclage when membranes are protruding through the dilated cervi x. Methods. Between 1988 and 1996 twenty-three pregnant patients with dilated cervix and protruding membranes were treated with emergency cerclage. At th e time of cerclage, gestational age ranged from 17 to 27 weeks (median 22). Results. Pregnancy was prolonged from 0 to 20 weeks (median 4). Eleven livi ng infants were born (46%); median gestational age at delivery was 25 weeks (range 21-39) and median birth weight 700 g (range 350-3980 g). Obstetric histories, white blood cell count, and vaginal-cervical and urine cultures obtained on admission were analyzed in the two following groups: data from patients with good pregnancy outcome (live births) versus those from patien ts with poor outcome (stillbirths and neonatal deaths). No significant diff erence was found between the groups for the above mentioned maternal featur es. Conclusions. The possibility of 46% live births is considered a good result for mid-trimester emergency cerclage when the membranes are protruding. Su ccess of the procedure remains unpredictable on the basis of the maternal f eatures investigated.