Prior cerclage: to repeat or not to repeat? That is the question.
Publication/Presentation Date
8-1-2008
Abstract
Our objective was to compare obstetrical outcomes of women with a prior cerclage for nontraditional indications who in the subsequent pregnancy either received a history-indicated cerclage or were followed by transvaginal ultrasound (TVU) cervical length (CL). All women with a history- or ultrasound- indicated cerclage in a prior pregnancy and who had a subsequent pregnancy were retrospectively identified from a preexisting database of women at risk for preterm birth between 1995 and 2002. Only women who reached >or= 12 weeks of gestation were included for analysis. Women with a diagnosis other than classic cervical insufficiency were managed in the subsequent pregnancy either by history-indicated cerclage or by serial TVU CL. The primary outcome was spontaneous preterm birth < 35 weeks. We identified 56 women with a prior cerclage for nontraditional indications. In the subsequent pregnancy, 28 women were followed with TVU and 28 matched controls received history-indicated cerclage. The groups were matched for demographics and risk factors. There were no differences between the two groups in the incidence of preterm labor < 35 weeks (21% versus 11%; P = 0.5), preterm premature rupture membranes < 35 weeks (7% versus 11%; P = 1.0), spontaneous preterm birth < 35 weeks (11% versus 11%; P = 1.0), or the gestational age at delivery (36.3 +/- 6.6 versus 36.5 +/- 5.6; P = 0.5). We concluded that in women with prior cerclage for indications other than classic cervical insufficiency, repeat history-indicated cerclage may not improve outcome compared with management with TVU CL follow-up.
Volume
25
Issue
7
First Page
417
Last Page
420
ISSN
1098-8785
Published In/Presented At
Pelham, J. J., Lewis, D., & Berghella, V. (2008). Prior cerclage: to repeat or not to repeat? That is the question. American journal of perinatology, 25(7), 417–420. https://doi.org/10.1055/s-2008-1075037
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
18546079
Department(s)
Administration and Leadership
Document Type
Article