Ahmed Ragab1, Yasser Mesbah2. 1. Department of Obstetrics and Gynecology, Mansoura College of Medicine, Mansoura University, Mansoura, Egypt. aragab69@yahoo.com. 2. Department of Obstetrics and Gynecology, Mansoura College of Medicine, Mansoura University, Mansoura, Egypt.
Abstract
PURPOSE: To measure the outcome of emergency cervical cerclage (ECC) combined with progesterone vs. progesterone alone in pregnancy prolongation for preterm labor at 24-28 weeks. METHODS:One hundred patients in early labor were allocated randomly into two equal groups. Group A were treated by ECC and progesterone, and group B were on the same progesterone dose only treatment. RESULTS: No significant differences were observed in both groups as regard demographic data, fetal gestational age or cervical state on admission. However, a significant pregnancy prolongation was observed in group A (28.44 ± 12.73 days vs. 9.96 ± 3.27 in group B, p < 0.001) with subsequent increase in fetal gestational age (32.04 ± 3.2 vs. 27.86 ± 3.213, p < 0.001), heavier weight, higher Apgar score at 1 and 5 min, and lower rate of cesarean delivery (1033.1 ± 170.83 vs. 715.1 ± 138.73, p < 0.001) (2.68 ± 1.132 vs. 2.14 ± 0.93, p < 0.001), (5.48 ± 2.6 vs. 2.38 ± 1.59, p = 0.01) and (16 vs. 62 %, p = 0.01), respectively. Also neonatal outcomes in terms of early neonatal deaths were lower in this group (18 vs. 46 %, p = 0.049). CONCLUSIONS:ECC is effective in pregnancy prolongation when judiciously used in combination with progesterone compared to progesterone alone.
RCT Entities:
PURPOSE: To measure the outcome of emergency cervical cerclage (ECC) combined with progesterone vs. progesterone alone in pregnancy prolongation for preterm labor at 24-28 weeks. METHODS: One hundred patients in early labor were allocated randomly into two equal groups. Group A were treated by ECC and progesterone, and group B were on the same progesterone dose only treatment. RESULTS: No significant differences were observed in both groups as regard demographic data, fetal gestational age or cervical state on admission. However, a significant pregnancy prolongation was observed in group A (28.44 ± 12.73 days vs. 9.96 ± 3.27 in group B, p < 0.001) with subsequent increase in fetal gestational age (32.04 ± 3.2 vs. 27.86 ± 3.213, p < 0.001), heavier weight, higher Apgar score at 1 and 5 min, and lower rate of cesarean delivery (1033.1 ± 170.83 vs. 715.1 ± 138.73, p < 0.001) (2.68 ± 1.132 vs. 2.14 ± 0.93, p < 0.001), (5.48 ± 2.6 vs. 2.38 ± 1.59, p = 0.01) and (16 vs. 62 %, p = 0.01), respectively. Also neonatal outcomes in terms of early neonatal deaths were lower in this group (18 vs. 46 %, p = 0.049). CONCLUSIONS: ECC is effective in pregnancy prolongation when judiciously used in combination with progesterone compared to progesterone alone.
Authors: George U Eleje; Ahizechukwu C Eke; Joseph I Ikechebelu; Ifeanyichukwu U Ezebialu; Princeston C Okam; Chito P Ilika Journal: Cochrane Database Syst Rev Date: 2020-09-24