Ünal İSAOĞLU, Mehmet YILMAZ, Sedat KADANALI

The results of cervical cerclage in a single center during a five-year period

Amaç: Bu çalışmanın amacı servikal serklaj uygulanan hastaları sonuçlarını ve bu işlemin gebeliğin devamına olan katkısını değerlendirmektir.Yöntemler: Atatürk Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalına Ocak 2002 ile 2007 Nisan tarihleri arasında başvuran ve servikal yetmezlik tanısı ile servikal serklaj uygulanan 29 olgunun verileri geriye dönüşlü olarak incelendi ve sonuçları değerlendirildi.Hastaların yaş, gebelik haftası, abortus veya preterm doğum hikâyesi, servikal serklaj hikâyesi, preoperatif serviksin transvajinal yolla uzunluğunun ölçülmesi, serklaj tipleri ve doğum haftaları kaydedildi ve değerlendirildi.Bulgular: Hastaların yaşları 24-43 arasında değişmekteydi. Gebelik haftaları ise 12 hafta 2 gün ile 26 hafta 1 gün arasında idi. Hastaların 19 (%65.5)’unda transvajinal ultrasonografik ölçümle serviks uzunluğu 20 mm’nin altında bulundu. 8 (%27.5) hastada funnelling bulgusu vardı. Toplam 16 hastaya profilaktik serklaj ve diğer 13 (%55.1) hastaya terapotik serklaj uygulandı. Serklaj sonrası 21 (%72.4) hastanın serviks uzunlukları 20 mm’nin üzerinde ölçüldü. Hastaların beşi terme ulaştı.Sonuç: Servikal yetmezlik için risk faktörü taşıyan hastalara rutin aralıklarla transvajinal ultrasonografi yapılması fetüs için hayat kurtarıcı olabilir. Yine servikal yetmezlik için tipik olan iki veya daha fazla ağrısız olarak 2.trimester düşüğü veya 3.trimester erken doğumu anamnezi veren hastalara profilaktik serklaj uygulamasının iyi bir seçenek olduğunu düşünmekteyiz.

Tek merkezde beş yıllık sürede uygulanan servikal serklaj sonuçları

Objectives: The aim of this study was to evaluate the results of the patients who underwent cervical cerclage placement and the contribution of this intervention to the maintenance of pregnancy.Methods: Data of 29 patients who underwent cervical cerclage placement due to cervical insufficiency in Ataturk University Medical Faculty Obstetrics and Gynecology Department Between January 2002 and April 2007 were retrospectively analyzed.The patient’s age, gestational week, history of abortion, history of previous cervical cerclage, preoperative measurement of cervical length, types of cerclage and delivery weeks were recorded and analysed.Results: The patient’s ages were between 24 and 43 years. Weeks of gestation were between 12 weeks 2 days and 26 weeks and 1 day. Nineteen patient’s cervical lengths were less than 20 mm by transvaginal ultrasonography. Eight of patients had funneling sign by transvaginal ultrasonography. Sixteen patients treated with prophylactic cervical cerclage, thirteen women treated with therapeutical cerclage. The cervical lengths of twenty one patients were over 20 mm after the procedure. Five patients reached term.Conclusion: The patient who has risk for cervical insufficiency should be followed with serial ultrasound examination and cervical cerclage should be performed when needed. The prophylactic cerclaje process is still best choice for patients with the history of two or more painless 2nd trimester or early 3rd trimester abortion that typical for cervical incompetence.

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