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Contribution of Cervical Plasty in the Management of Cervico-Isthmic Incompetency at the General Hospital of Lamentin in Martinique

Aboubakar M, Hounkponou ANMF, Obossou AAA, King VS, Santos GLB, Moulang, Dia O, Denakpo JL, Salifou K, Sidi IR, Vodouhe MV and Perrin RX

Objectives: To evaluate the influence of pre-conception cervical plastic surgery on the prognosis of pregnancy in women with a history of abortive disease through cervical incompetence.

Method: Retrospective study over a period of 20 years, from January 1990 to June 2010. We carried out an exhaustive census of the patients with a cervico isthmic gap, who benefited of a pre-pregnancy cervical plasty associated with a systematic cervical cerclage carried out in the first trimester of pregnancy.

Results: We identified 10 files that met the inclusion and non-inclusion criteria. The mean age of the patients was 33.8 years. They were multigravida (extremes 2 and 10) and pauciparous (mean parity was low of 1.29). The history of recurrent spontaneous miscarriage was found in all women. The diagnosis of cervico isthmic gap was evoked on the basis of clinical and paraclinical arguments. Seven women got pregnant for a total of nine pregnancies. All pregnancies have reached the age of viability which was 24SA. The prematurity rate was 4/9 pregnancies and the average gestational age for preterm delivery was 31 SA. Five pregnancies evolved to term and the average term for childbirth was 38 SA+6 days.

Conclusion: Pre-pregnancy cervical plasty associated with cervical cerclage in the first trimester of pregnancy has yielded interesting results in the prevention of preterm delivery in patients with cervico-isthmic gap. A study on a larger sample is necessary to draw conclusions.