Cervical cerclage versus weekly progesterone injection in prevention of preterm labor

Ahmed Taha Abdel Fatth, Abdel-Samie Abdel Mahmoud El-Seheimy,

doi:10.21608/egyfs.2015.257493

Cervical cerclage versus weekly progesterone injection in prevention of preterm labor

Document Type : Original Article

Author

Abdel-Samie Abdel Mahmoud El-Seheimy, Ahmed Taha Abdel Fatth ¹^{, 2}^{, 3}

¹ Faculty of Medicine, Fayoum University, OB/GYN Department

² Faculty of Medicine, ALAzhar University, Assiut, OB/GYN Department

³ Faculty of Medicine, ALAzhar University, Cairo, OB/GYN Department

10.21608/egyfs.2015.257493

Abstract

Objective: Prematurity is the leading cause of neonatal death and handicap. Although all births before 37 weeks of gestation are defined as preterm, most damage and death occurs in infants delivered before 34 weeks.
Improvements in neonatal care have led to higher rates of survival among
very premature infants, but a major effect on the associated mortality and
morbidity will be achieved by better Identification of women at high risk
for preterm delivery and by development of an effective intervention to
prevent this complication. The aim of this study is to compare the effect
of weekly progesterone injection and cervical cerclage on the outcomes of
pregnancy in patients with history of preterm labor.
Materials & Methods: The study comprised of 80 patients involved in the
study then, 20 patients were excluded from the study due to different causes. Patients were randomly allocated to two groups. Randomization was
done by sealed envelopes. Group A: (30 patients); in this group we had
given them 17 OH progesterone (cidulot depot 250 mg) IM weekly starting from 16-20 Weeks till 36 weeks gestation. Group B: (30 patients); in
this group we had done cervical cerclage operation at 14 weeks. First we
assessed the effect of cidulot depot on the gestational age in comparison to
the gestational age at previous preterm deliveries in group A. Secondly we
assessed the effect of cervical cerclage on the gestational age in comparison to the gestational age at previous preterm deliveries in group B. The
primary outcome was the gestational age at time of delivery documented
by the LMP and abdominal US. The secondary outcomes were the need
to the tocolytic therapy, estimated fetal weight at the time of delivery, the
neonatal outcome regarding admission to the incubator or the need to ICU
admission and neonatal mortality.
Results: of the study were analyzed, matched and compared.
Conclusion: We concluded that the prophylactic administration of progesterone beginning in mid-gestation to women who previously had a preterm
birth has been shown to reduce the rate of recurrence. Also use of prophylactic cervical cerclage reduces preterm labor but the preference of which
method remains an area of discussion.

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