Short cervical length after history-indicated cerclage: is a reinforcing cerclage beneficial?

Publication/Presentation Date

9-1-2005

Abstract

OBJECTIVE: The purpose of this study was to determine if a reinforcing cerclage improves outcome in women with a history-indicated cerclage who develop a short cervix on ultrasound.

STUDY DESIGN: The management of women with a history-indicated transvaginal cerclage who subsequently developed a short cervix (< or = 25 mm) on transvaginal ultrasound before 24 weeks was retrospectively reviewed. Exposed subjects that received a reinforcing cerclage were compared with similar unexposed subjects that were followed with expectant management. The primary outcome was preterm delivery < 35 weeks.

RESULTS: Twenty-four eligible women were identified, of which 5 received a reinforcing cerclage and 19 were managed expectantly. There was no difference in patient demographics and risk factors between the exposed and unexposed groups. Reinforcing cerclage was associated with a significantly earlier gestational age at delivery (20.8 vs 32.9 weeks, P = .002) as well as higher rates of both preterm delivery < 35 weeks (100% vs 32%, P = .01) and previable delivery < 24 weeks (80% vs 16%, P = .01).

CONCLUSION: In pregnancies with a history-indicated cerclage and subsequently diagnosed ultrasound cervical shortening before 24 weeks, placement of a reinforcing cerclage is associated with earlier delivery than expectant management.

Volume

193

Issue

3 Pt 2

First Page

1204

Last Page

1207

ISSN

0002-9378

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

16157138

Department(s)

Administration and Leadership

Document Type

Article

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