Effectiveness of cerclage according to severity of cervical length shortening: a meta-analysis.
OBJECTIVES: To estimate the effectiveness of cerclage according to degree of cervical length (CL) shortening.
METHODS: A meta-analysis was carried out of trials of women with singleton gestations and second-trimester transvaginal sonographic CL < 25 mm randomized to cerclage or no cerclage. The degree of CL shortening was correlated to the efficacy of cerclage in preventing preterm birth.
RESULTS: There was a significant reduction in preterm birth < 35 weeks in the cerclage compared with no cerclage groups in 208 singleton gestations with both a previous preterm birth and CL < 25 mm (relative risk, 0.61; 95% CI, 0.40-0.92). In these women, preterm birth < 37 weeks was significantly reduced with cerclage for CL < or = 5.9 mm, < or = 15.9 mm, 16-24.9 mm and < 25 mm. None of the analyses for 344 women without a previous preterm birth was significant.
CONCLUSIONS: Cerclage, when performed in women with a singleton gestation, previous preterm birth and cervical length < 25 mm, seems to have a similar effect regardless of the degree of cervical shortening, including CL 16-24 mm, as well as CL < or = 5.9 mm.
Published In/Presented At
Berghella V, Keeler SM, To MS, Althuisius SM, Rust OA. Effectiveness of cerclage according to severity of cervical length shortening: a meta-analysis. Ultrasound Obstet Gynecol. 2010 Apr;35(4):468-73. doi: 10.1002/uog.7547. PMID: 20052661.
Medicine and Health Sciences
Department of Obstetrics and Gynecology