Effectiveness of elective cervical cerclage according to obstetric history.
J Gynecol Obstet Hum Reprod
; 46(1): 53-59, 2017 Jan.
Article
in En
| MEDLINE
| ID: mdl-28403957
ABSTRACT
OBJECTIVE:
To assess the effectiveness of elective history-indicated cervical cerclage according to obstetrical history. STUDYDESIGN:
We analyzed pregnancy outcome of a retrospective cohort of women who have had history-indicated McDonald's cerclage. Principal outcome was gestational age (GA) at delivery.RESULT:
Between January 2003 and December 2013, 205 women were included. We analyzed population in two risk groups 1- Low-risk (≤2 prior preterm birth (PTB)/second trimester loss (STL), or prior success of cerclage), 2- High risk (≥3 prior PTB/STL, or prior failure of cerclage). In the high-risk group, there was a higher frequency of deliveries before 37 weeks (47.5% vs. 24.5%, P=0.001, OR=2.79, 95% CI [1.49-5.23]). Fifty percent of women (n=6/12) delivered before 37 weeks in case of three or more prior PTB/STL, and 51% (n=24/47) in case of prior failure of cervical cerclage.CONCLUSION:
Elective cervical cerclage may be indicated for women with≤2 prior PTB/STL, or prior successful cerclage. For women with≥3 prior PTB/STL, trachelorraphy or cervico-isthmic cerclage could be possible alternatives to cervical cerclage.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Uterine Cervical Incompetence
/
Elective Surgical Procedures
/
Cerclage, Cervical
/
Premature Birth
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Middle aged
/
Pregnancy
Country/Region as subject:
Europa
Language:
En
Journal:
J Gynecol Obstet Hum Reprod
Year:
2017
Document type:
Article