[Results of early total cervix occlusion (ETCO) according to Saling in multiple pregnancies--a retrospective study of the period 1995 to 2005].

BACKGROUND

Due to the ever-improving possibilities in reproductive medicine, the number of multiple pregnancies has increased constantly within the last years. Accordingly, the group of extremely preterm born children presents an important, if not even increasing, percentage within the group of multiple births. Intensifying prematurity prevention is a particular necessity within this group of patients. Against this background we consider generous indications for treatment with early total cervix occlusion (ETCO) according to Saling in the first trimester of multiple pregnancies to be necessary.

METHODS

In a retrospective study we compared two groups of patients with multiple pregnancies who delivered in our clinic between 1995 and 2005. Patients from the first group were treated by ETCO (n = 96) within the first trimester of pregnancy whereas this treatment was not used on patients from the reference group (n = 123).

RESULTS

The main results of our study are: - A significant lowering of extreme premature births below 32 weeks of gestation by the performance of the ETCO procedure. - A significant increase of mature born children within the ETCO group (32.8 versus 19.8 %). Furthermore, the decreasing incidences of foetal acidosis as well as the positive effect on perinatal mortality in general due to the performance of the ETCO procedure in plural pregnancies are apparent as trends although the results show no statistical significance at this point in time. Only one newborn (0.5 %) within the ETCO group was affected by severe acidosis with a pH value below 7.1 as compared with 5 newborns (2.5 %) within the group not undergoing ETCO treatment.

DISCUSSION AND

CONCLUSION

With 6 triplet pregnancies, the number of high-risk multiple pregnancies was obviously higher within the ETCO group, thus perinatal mortality within this group was approximately half that in the reference group (2.52 versus 4.05 %).