Cervical Insufficiency and Perinatal Outcome in a Tertiary Hospital in Yenagoa, South-South, Nigeria

Abstract

Background: Cervical insufficiency has been defined by the American College of Obstetricians and Gynaecologists (ACOG) as inability of the cervix to retain a pregnancy in the second trimester, in the absence of uterine contractions. It is an important contributor to the incidence of preterm delivery, perinatal morbidity and mortality in our sub-region. Objective: To determine the prevalence of cervical insufficiency and the perinatal outcome at the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria over a 5-year period. Materials and Methods: This retrospective study was carried out between 1st January, 2016 and 31st December, 2020. Data were retrieved, entered into a pre-designed proforma, and analysed using IBM SPSS version 25.0. Results were presented in frequencies and percentages. Results: There were a total of 4,571 deliveries, and 59 of the pregnancies were complicated by cervical insufficiency giving prevalence of 1.29% or 12.9 per 1,000 pregnancies. Most of the cerclage were history indicated (74.6%). About 7 in 10 women (71.2%) who had cervical insufficiency had vaginal delivery. Majority of the cerclage (77.2%) were removed at term and median age at removal of cerclage was 37 weeks. The mean cerclage removal to delivery interval was 8.1 days. Conclusion: Cervical insufficiency is a distressing condition both for the obstetrician and the couple due to the psychological effect of recurrent pregnancy loss. Avoiding acquired predisposing factors, early booking for antenatal care, prompt insertion of cervical cerclage for women with cervical insufficiency are key in preventing associated perinatal morbidity and mortality.