Mcdonald Cervical Cerclage on Cervical Incompetence Patients

Objective: Mcdonald cervical cerclage is the widely-used method for cervical incompetence (IC)patients nowadays. However, the circle number and whether need to put aprons or how many aprons to put are still controversial. The purpose of this study is to discuss the influence of different modes of Mcdonald cerclage on pregnancy outcomes.

Methods: A retrospective analysis of all patients who accepted Mcdonald cervical cerclage in our hospital from 2014.01.01 to 2015.12.30 was taken, with live-birth rate as the primary observation parameters. Analysis the differences of live-birth rates among different doctors and different cerclage ways.

Results: A total of 294 CI patients accepted Mcdonald cerclage, 260 were followed-up till delivery. 32 patients were lost, 2 patients terminated pregnancy because of fetal malformation. 80 patients accepted rescued cerclage, 48 patients accepted emergency cerclage and 132 patients accepted preventive cerclage, 215 patients delivered after 28th gestational week, 45 patients delivered before 28th gestational week(however 10 inevitable abortion babies were survived) . The total live-birth rate was 86.5%(225/260), with 91.4%(72/80,rescue cerclage)68.4%(33/48, emergency cerclage)and 90.9%(120/132, preventive cerclage), respectively(P=0.000). There were no statistical differences among different doctors on pregnant outcomes(p=0.580). There were no statistical differences between one circle and two circles of cerclage(P=0.705). There were no statistical differences among subgroups divided by apron numbers (0/1/2/3) on live-birth rates. However, a lower secondary cerclage(20 patients accepted secondary cerclage because of cervical dilation after first cerclage without infection and ) rate was observed in 2 aprons group. Meanwhile, the liver-birth rate was 60%(12/20) after secondary cerclage.

Conclusion: Mcdonald cervical cerclage is an opration which can be easily mastered. Rescued cerclage and preventive cerclage had good effects. Circle numbers and apron numbers do not influence pregnant outcomes. Secondary cerclage was recommended to patients who suitable for it.