27Mar 2017

PREGNANCY OUTCOME IN SHORT CERVIX: PROGESTERONE VS CERVICAL ENCERCLAGE.

  • Resident, Department of Obstetrics and Gynaecology, BharatiVidyapeeth Deemed University Medical College, Pune, Maharashtra, India.
  • Professor, Department of Obstetrics and Gynaecology, BharatiVidyapeeth Deemed University Medical College, Pune, Maharashtra, India.
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Introduction: Preterm birth (PTB), defined as birth before 37 weeks of gestation, is the leading cause of perinatal morbidity and mortality. A sonographic short cervix has emerged as a powerful predictor of preterm birth. The present study was conducted to compare the outcome of pregnancy with short cervix with natural micronized progesterone and cervical cerclage. Materials & Methods: A Prospective Comparative study was conducted in the Department of Obstetrics and Gynaecology of a Tertiary Care Hospital and Medical college. A total of 50 cases of short cervix were included in the study. Out of 50 cases, 25 cases each were divided in two groups by simple random sampling: Group A: Given natural micronized progesterone; and Group B: Underwent cerclage procedure. Detailed history, ANC check-up, USG and appropriate investigations were carried out for each subject. The cases were followed thereafter in antenatal clinic till delivery and pregnancy outcome was noted. Results: The mean maternal age was 22.44 years in progesterone group and 22.64 years in cerclage group (p-0.514). The outcome of pregnancy with natural micronised progesterone reflected 36% births between 28-32 weeks of gestation, 28% after completion of 37 weeks and only 16% before 28 weeks of gestation whereas outcome with cerclage 36% between 28-32 weeks, 44% after completion of 37 weeks and 8% before 28 weeks (p-0.56). The difference in secondary outcome measures (PPROM, LSCS rate)and neonatal outcome (mean birth weight, APGAR, duration of NICU admission, respiratory distress, development of IVH, NEC and neonatal sepsis) in cerclage and progesterone group was also statistically non-significant (p>0.05) Conclusion: Natural micronized progesterone is as effective as cervical cerclage in prevention of premature labour in women with short cervix. Use of natural micronized progesterone is more preferable in clinical practice because it is non-invasive technique, easy to administer and the patients do not suffer from surgical and anaesthesia procedure related adverse effects. It is also not associated with any hospital stay and is very economical.

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[Nikita Gandotra and Vandana Nimbargi. (2017); PREGNANCY OUTCOME IN SHORT CERVIX: PROGESTERONE VS CERVICAL ENCERCLAGE. Int. J. of Adv. Res. 5 (Mar). 1144-1150] (ISSN 2320-5407). www.journalijar.com

Dr. Nikita Gadotra
Department of Obstetrics and Gynaecology, BharatiVidyapeeth Deemed University Medical College, Pune, Maharashtra, India

DOI:

Article DOI: 10.21474/IJAR01/3618      
DOI URL: https://dx.doi.org/10.21474/IJAR01/3618

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