Cervical insufficiency, management and outcomes at a top healthcare facility in southern Nigeria

When pregnancy terminates in spontaneous miscarriage, the desire and effort to reproduce ends in disappointment. Hopelessness and frustration sets in when it becomes repetitive. The objectives of this study were to determine the prevalence, sociodemographic, clinical presentation and outcome of surgically managed cases of cervical insufficiency.The study was a descriptive retrospective study which was carried out on managed cases of cervical insufficiency at the Obstetrics and Gynaecology department of the Federal Medical Centre, Yenagoa, Bayelsa State. The prevalence of cervical cerclage in our facility is 0.23%. A significant number of cases were seen among those aged 35 and above and were nulliparous.  The commonest clinical presentation prior to cerclage insertion was recurrent miscarriage (43.7%) and indication for cervical cerclage insertion was history indicated cerclage (53.1%). All patients had McDonald’s method of cervical cerclage. Elective cerclage accounted for 65.6% of cases. The success rate following insertion of cerclage was 79.1%.Cervical insufficiency is a major cause of mid-trimester fetal wastages with a prevalence of 0.23% in this study, commoner among the nulliparous women aged 35 year and above, presenting commonly with recurrent miscarriages. History indicated cerclage is the most common indication for insertion of cerclage and an appreciable success rate was recorded. McDonald’s method of cerclage insertion is the preferred method in our centre.The use of cervical cerclage for cases of cervical insufficiency is associated with prolongation of pregnancy and reduction in perinatal morbidity and mortality.