Comparison of Outcomes of Incompetent Cervix Patients Treated with the Transvaginal Cerclage and the Modified Transvaginal Cerclage using Fibrin Sealant

Lee, Sung Hoon; Yoon, Hae Jin; Lee, Yong Uk; Kim, Hyun Hee; Han, Hyun Ju; Park, Moon Il; Hwang, Jeong Hyae; Moon, Hyung; Chung, Sung Ro

Abstract

OBJECTIVE: The purpose of our study is to compare the outcome of the modified transvaginal cerclage (MTVC) in patients who had not undergone a previous TVC with the outcome of patients treated with the transvagianl cerclage (TVC). METHOD: Incompetent cervix patients in the Obstetric/Gynecology department of Hanyang University Hospital post January, 1996 were selected as subjects for this study. 94 patients who received the TVC and 44 patients who received the MTVC using fibrin sealant were compared. The success of the operation was determined in the 34th week of pregnancy, and duration of pregnancy. RESULTS: Clinical characteristics of the TVC group and the MTVC group are showing no significant statistical difference between the two groups. The average gestational age of delivery was 36.0 and 37.0 week and the average weight was 2,797 g and 2,828 g respectively, also showing no significant (p=0.06) statistical difference. However, the duration of pregnancy between surgery and birth was 19.5 and 21.5 weeks showing significant (p=0.013) statistical difference, when the success rates of the treatments of incompetent cervix were observed according to the 34th week standard, TVC showed a 74% (71/96) rate of success and MTVC with fibrin sealant showed a 90.9% (40/44) rate of success, showing a significant statistical difference (Chi(2)=4.503, p<0.05). CONCLUSION:The success rate of MTVC using fibrin sealant showed to be significantly higher than the success rate of TVC. The reason for the difference in success rates is suspected to be because the fibrin sealant injected between the two TVC bands blocked the possibility of infection originating in the vagina. In the future, further research should focus on cultures of vaginal and amniotic fluids.