Previously we showed that finding of intra-amniotic “sludge” (IAS), an ultrasound (US) finding of hyperechoic matter in the amniotic fluid (AF) close to cervical internal os, did not change pregnancy outcome in asymptomatic patients (pts) undergoing high cerclage for sonographically short cervix (Cx). We aim to find if addition of 22 pts to previously reported 46 changes the result.METHODS:
Records of 68 consecutive pts, who underwent high MacDonald cerclage between 16–24 6/7 weeks (wks) for a sonographically short Cx (<25 mm) between 2007–2015 were evaluated. Transvaginal US images were evaluated for cervical length, funneling and presence of IAS. Baseline morphological characteristics and pregnancy outcomes were compared between those with and without IAS.RESULTS:
Of 68 pts, 36 had IAS present and 32 did not. Pts with IAS had shorter Cx at time of cerclage 9.9±7 vs 13.7±6.7 mm (P=.025) and more cervical funneling (P=.022). Other baseline characteristics were largely similar. Pregnancy outcomes were similar for delivery rates at gestational age (GA) with mean; 36 1/7±4 wks for IAS, 36 4/7±4 2/7 wks for no IAS (P=.719), and neonatal weight; 2745 (808) grams vs. 2938 (827) grams (P=.356).CONCLUSION:
Despite associated differences in Cx funneling and shorter Cx, presence of IAS did not affect pregnancy outcome in GA at delivery or neonatal birth weight. These results suggest that presence of IAS does not contraindicate use of optimally placed cerclage in asymptomatic pts who are candidates for cerclage.