Prophylactic Trans-vaginal Cervical Cerclage versus Conservative Management in Triplet Pregnancies

Background: To compare the effect of prophylactic trans- vaginal cervical Cerclage versus the conservative treatment in management of triplet pregnancies and also the effect of parity on gestational age and birth weight in triplet pregnancies.
Patients and Methods: 40 women with triplet pregnancies were divided into 2 groups. Group 1 (20) received prophylactic cerclage. Group 2 (20) with no Cerclage [conservative management]. Each group subdivided into two half ; half of the women were primi-para and the other half were multi-para (including unipara &multi-para), women with possibility of cervical insufficiency were excluded and pregnancy was followed in all women until delivery.
Results: There was no significant difference between the both groups regarding the gestational age at time of delivery (31.45±4.68 in Cerclage group versus 32.65±4.01 in non Cerclage), the miscarriage rate (20% in Cerclage versus 15% in conservative management group) and time of delivery (35% delivered before 34 w, 35% between 34w and 36w, and 10% after 36w in cerclage group versus 35%, 40%, 10% in conservative management group respectively).
There was no significant difference between both groups regarding the neonatal birth weight (1390±467.24 in cerclage group versus 1405±475.7 in conservation group) & NICU admission (90% in both groups). parity has effect on gestational age of delivery (75% of prime para delivered before 34 wks. 20 % between 34-36 weeks and 5% after 36weeks while in multi para (35%,40%, and 10%) respectively.
Conclusion: Prophylactic trans- vaginal cervical cerclage in triplet pregnancies regarding pregnancy prolongation and neonatal outcomes is similar to conservation. Parity has effect on pregnancy prolongation & consequently the neo-natal outcomes.