History-indicated cerclage: the association between previous preterm history and cerclage outcome
Obstetrics & Gynecology Science
; : 23-29, 2018.
Article
de En
| WPRIM
| ID: wpr-741733
Bibliothèque responsable:
WPRO
ABSTRACT
OBJECTIVE: Our hospital's policy is to perform history-indicated cerclage (HIC) for pregnant patients with 1 or more second-trimester pregnancy losses. Recently, the American College of Obstetricians and Gynecologists (ACOG) guideline regarding indications for HIC was changed from 3 or more previous second-trimester fetal losses to one or more. In this study, we aimed to evaluate the efficacy of the revised guideline and to investigate the association between previous preterm history and cerclage outcome. METHODS: We conducted a retrospective observational study of cases of HIC in singleton pregnancies performed at our hospital between January 2007 and June 2016. We compared the perioperative complications and incidences of preterm delivery in patients with one previous second-trimester pregnancy loss against those in patients with ≥2 losses. RESULTS: The incidence of preterm delivery (< 32 weeks) was significantly lower in patients with one previous second-trimester pregnancy loss than in those with ≥2 losses (15/194 [8%] vs. 28/205 [14%]). In the 1 loss and ≥2 losses groups, the rates of preterm premature rupture of membranes (PPROM) were 7% and 8%, the rates of PPROM at < 32 weeks 2.1% and 3.4%, and the ratios of neonatal intensive care unit admission 10% and 17%, respectively. CONCLUSION: Comparison of HIC in one previous second-trimester pregnancy loss group with HIC in the 2 or more previous second-trimester pregnancy loss group found no difference in pregnancy outcome. This finding supports the amended ACOG guideline for HIC indications. Based on our results, we also propose development of a new protocol for HIC-related complications.
Mots clés
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Rupture
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Issue de la grossesse
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Soins intensifs néonatals
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Béance cervico-isthmique
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Incidence
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Études rétrospectives
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Cerclage cervical
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Naissance prématurée
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Étude d'observation
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Membranes
Type d'étude:
Incidence_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limites du sujet:
Female
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Humans
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Newborn
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Pregnancy
langue:
En
Texte intégral:
Obstetrics & Gynecology Science
Année:
2018
Type:
Article