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\begin{document}

\title{Gestational and Neonatal Outcomes of a New Three-Step Procedure for
Emergency Cerclage}



\author[1]{Lorena Sabonet Morente}%
\author[1]{Manuel Gómez Castellano}%
\author[2]{Ernesto González Mesa}%
\author[1]{Jesús S Jiménez López}%
\affil[1]{Hospital Materno-Infantil}%
\affil[2]{University of Malaga}%


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  \date{May 16, 2024}


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\begin{abstract}
Objective:The objective of our study was to evaluate a new technique for
emergency cerclage performed in a cohort of patients with cervical
incompetence in the second trimester of pregnancy.Design:Prospective
observational studySetting:HMIPopulation:24pregnant women at 15 to 24 wk
gestation with cervical dilatation and bursa prolapsed.Methods:Depending
on the clinical condition of the patient, a new emergency cerclage was
performed with a technical consisting of a first cerclage in a
purse-string and a second occlusive cerclage located inferiorly to the
first one.The technique ended with the performance of a cervical
cleisis, depending on the presence or absence of prolapse.This procedure
is called the Three-Step Procedure for Emergency Cerclage (TSEC).Outcome
measureLatency period to deliveryResults:Latency from procedure to
delivery, pregnancy duration, infant birth weight, rate of premature
amniorrhexis.The mean latency from procedure to delivery was 14 weeks +
6 days, the mean weight of the newborns was 2550 g, and the mean age at
delivery was 35 weeks.The neonatal survival rate was 95.8\%. The rate of
premature amniorrhexis\textless{}34 weeks was 8.3\% with successful
perinatal outcomes. There were significant differences (p \textless{}
0.05) between groups when we sub-divided the cohort in terms of history
of conization,preterm delivery,and bursal prolapse.The multivariate
regression model showed that best predictor variables for latency to
delivery were cervical dilatation at diagnosis, the use of the
TSEC,cervical length after the procedure, and gestational age at
diagnosis.Conclusion:The excellent results obtained with the TSEC
procedure in terms of the latency from procedure to delivery,
gestational age at delivery, birth weight, and few reported
complications%
\end{abstract}%



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