Can prophylactic transvaginal cervical cerclage improve pregnancy outcome in patients receiving cervical conization? A meta-analysis.

OBJECTIVES: Cervical conization could increase the risk of cervical insufficiency. This study systematically evaluated the value of prophylactic transvaginal cervical cerclage following cervical conization with regards to pregnancy outcome. MATERIAL AND METHODS: We performed a systematic review of the literature, using Web of Science, and Embase, the published time ranged from the date that database established to December 2019. Pregnant patients, who had a previous history of cervical conization for CIN or early cervical cancer, were enrolled. Two researchers searched these databases and estimated the included studies' quality independently, depending on the same criteria. RESULTS: Our meta-analysis is incorporate 3560 cases eventually. Meta-analysis showed that when compared to the no-cerclage group, the risk ratio (RR) of preterm birth in the prophylactic transvaginal cervical cerclage group was 1.85 [95% confidence interval (CI): 1.22-2.80; p = 0.004]; the RR of premature rupture of membranes was 1.5 (95% CI: 1.17-1.93; p = 0.001). CONCLUSIONS: The rates of preterm birth were significantly higher in women following cervical conization with transvaginal cerclage than those without cerclage.