ORIGINAL RESEARCH
Obstetrics and Gynecology
doi: 10.25005/2074-0581-2025-27-1-22-32
EFFICACY OF EMERGENCY TRANSVAGINAL CERVICAL CERCLAGE

G.L. DRANDROV¹, E.G. DRANDROVA², S.I. TROFIMOVA¹, D.G. DRANDROV¹, G.ZH. ZHARYLKASYNOVA³, R.U. YULDASHOVA³, E.L. NIKOLAEV²

1City Clinical Hospital № 1, Cheboksary, Russian Federation
2I.N. Ulyanov Chuvash State University, Cheboksary, Russian Federation
3Bukhara State Medical Institute named after Abu Ali ibn Sino, Bukhara, Republic of Uzbekistan

Objective: To study the effectiveness of emergency cerclage in late pregnancy using double-level versus single-level sutures in the management of cervical insufficiency (CI).

Methods: The study is a retrospective analysis of medical records for 215 pregnant women who were hospitalized between 2016 and 2024 at the Perinatal Center of the City Clinical Hospital № 1, Cheboksary, Russian Federation, with a diagnosis of CI. The patients underwent emergency cervical cerclage (CC) between 19 and 27 weeks of pregnancy. The study compared the effectiveness of the single CC, using the McDonald technique (Group 1, n=102), to the double CC, according to G.L. Drandrov (Group 2, n=113). Pregnancy outcomes, neonatal outcomes, and complications from the surgical intervention were assessed.

Results: The frequency of premature births before 32 weeks of pregnancy was similar between the study groups. However, between 32 and 37 weeks of pregnancy, the rate of premature births significantly increased in the single CC group using the McDonald method compared to the double CC group (38.2% and 18.6%, respectively, p=0.002). In contrast, full-term live births were notably higher in the double CC group than in the single CC group (66.4% and 46.1%, respectively, p=0.002). In both groups, vaginal deliveries were predominant (85.3% in the single CC group compared to 89.4% in the double CC group, p>0.05). Regardless of the delivery method, nearly all pregnancies resulted in live births (99% in the single CC group compared to 100% in the double CC group, p>0.05). The average birth weights were 3087 g in the single CC group and 3117 g in the double CC group. Additionally, premature rupture of membranes (PROM) occurred during the first two weeks after CC in 4.9% of cases in the single CC group and 2.65% in the double CC group.

Conclusion: Double CC is more effective for surgical treatment of CI when performed for emergency indications. This technique results in a statistically significant reduction in premature birth rate between 32 and 37 weeks while increasing the rate of full-term live births. Moreover, a more substantial proportion of births occur through vaginal delivery, and regardless of the delivery method, there was an increase in the live births rate. The survival rate of newborns beyond 28 days is higher, and neonatal mortality is correspondingly 1.7 times lower.

Keywords: Cervical insufficiency, emergency cerclage, premature birth, prolapsed membranes.

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Authors' information:

Drandrov Gennadiy Leonidovich,
Candidate of Medical Sciences, Head of the Maternity Unit, City Clinical Hospital № 1
ORCID ID: 0000-0001-9627-3131
SPIN: 5908-6112
E-mail: drandrovg@yandex.ru

Drandrova Elena Gennadievna,
Candidate of Medical Sciences, Associate Professor, Associate Professor of the Department of Normal and Topographic Anatomy with Operative Surgery, Ulyanov Chuvash State University
ORCID ID: 0000-0003-3341-3373
SPIN: 1162-7816
E-mail: drandrov@yandex.ru

Trofimova Svetlana Ivanovna,
Obstetrician-Gynecologist of Pregnancy Pathology Department, City Clinical Hospital № 1
ORCID ID: 0009-0002-8538-1924
E-mail: trofimova.swetick@yandex.ru

Drandrov Dmitriy Gennadievich,
Obstetrician-Gynecologist of Obstetric Department, City Clinical Hospital № 1
ORCID ID: 0009-0005-8209-4905
SPIN: 9747-8504
E-mail: drandrovd@gmail.com

Zharylkasynova Gavkhar Zhanuzakovna,
DSc, Full Professor, Vice-Rector of Bukhara State Medical Institute named after Abu Ali ibn Sino
ORCID ID: 0000-0002-9374-3887
SPIN: 2391-4767
E-mail: gavhar72@inbox.ru

Yuldashova Rano Urinbaevna,
PhD, Dean of the Faculty of Postgraduate Education, Bukhara State Medical Institute named after Abu Ali ibn Sino
ORCID ID: 0000-0003-4936-6006
E-mail: dr-rano@mail.ru

Nikolaev Evgeniy Lvovich,
Doctor of Medical Sciences, Full Professor, Head of Social and Clinical Psychology Department, I.N. Ulyanov Chuvash State University
ORCID ID: 0000-0001-8976-715X
SPIN: 6574-0189
E-mail: pzdorovie@bk.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Drandrova Elena Gennadievna
Candidate of Medical Sciences, Associate Professor, Associate Professor of the Department of Normal and Topographic Anatomy with Operative Surgery, I.N. Ulyanov Chuvash State University

428015, Russian Federation, Chuvash Republic, Cheboksary, Moskovskiy Ave., 15

Tel.: +7 (905) 1982791

E-mail: drandrov@yandex.ru


This work is licensed under a Creative Commons Attribution 4.0 International License.

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