Cervical length and delivery outcomes in patients with prophylactic cervical cerclage.

We sought to determine the relationship between cervical length and delivery outcome in patients who received prophylactic cervical cerclage. We performed a retrospective cohort study of patients with singleton gestations who underwent cerclage during calendar years 1999 to 2008. A total of 78 patients were included in the study. Multiple clinical characteristics and their relationships to delivery outcome were analyzed using multivariable logistic regression analysis. Cervical length at the time of surgery and history of one or more prior second-trimester losses were strongly associated with delivery at or after 32 weeks gestation ( P = 0.005 and P = 0.01, respectively). In fact, a cervical length greater than 2 cm at the time of surgery was associated with delivery at 32 weeks or greater (odds ratio 5.74, 95% confidence interval 1.78 to 18.5; P = 0.003). Cervical length was associated with the delivery outcome of patients with prophylactic cerclage and may be helpful in selection of surgical candidates.

[1]  T. Goodwin,et al.  Preterm Labor: Diagnosis and Management , 2010 .

[2]  L. Impey,et al.  Emergency cervical cerclage: Predictors of success , 2010, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[3]  V. Berghella,et al.  Interval to spontaneous delivery after elective removal of cerclage. , 2009, American journal of obstetrics and gynecology.

[4]  M. Ramirez,et al.  Use of the Cervical Cerclage: Comparison of a Community and University Hospital Setting , 2007, Obstetrics and gynecology.

[5]  H. Honest,et al.  Cervical cerclage for prevention of preterm delivery: meta-analysis of randomized trials. , 2004, Obstetrics and gynecology.

[6]  W. Grobman,et al.  Factors Associated With Success of Emergent Second‐Trimester Cerclage , 2003, Obstetrics and gynecology.

[7]  J. Harger Cerclage and cervical insufficiency , 2002 .

[8]  H. V. van Geijn,et al.  Final results of the Cervical Incompetence Prevention Randomized Cerclage Trial (CIPRACT): therapeutic cerclage with bed rest versus bed rest alone. , 2001, American journal of obstetrics and gynecology.

[9]  J. Balducci,et al.  A randomized trial of cerclage versus no cerclage among patients with ultrasonographically detected second-trimester preterm dilatation of the internal os. , 2000, American journal of obstetrics and gynecology.

[10]  E. Schiff,et al.  Outcome of second-trimester, emergency cervical cerclage in patients with no history of cervical incompetence. , 1996, American journal of perinatology.

[11]  O. Olatunbosun,et al.  Emergency cerclage compared with bed rest for advanced cervical dilatation in pregnancy. , 1995, International surgery.

[12]  J. Dansereau,et al.  Emergency Cervical Cerclage: A Retrospective Review of 51 Cases , 1993, American journal of perinatology.

[13]  I. Chalmers,et al.  Final report of the Medical Research Council/Royal College of Obstetricians and Gynaecologists Multicentre Randomised Trial of Cervical Cerclage , 1993 .

[14]  R. Renaud,et al.  Multicentred controlled trial of cervical cerclage in women at moderate risk of preterm delivery , 1984, British journal of obstetrics and gynaecology.

[15]  J. Aarnoudse,et al.  Complications of cerclage , 1979, Acta obstetricia et gynecologica Scandinavica.

[16]  T. N. Evans,et al.  Cerclage for cervical incompetence. , 1967, Obstetrics and gynecology.

[17]  W. B. Stromme,et al.  Intrauterine fetal death in the second trimester. , 1963, American journal of obstetrics and gynecology.

[18]  D. Hayt,et al.  The physiology and clinical significance of the uterine isthmus. I. The two-stage intrauterine ballon in the diagnosis and treatment of cervical incompetence. , 1961, American journal of obstetrics and gynecology.

[19]  I. McDonald SUTURE OF THE CERVIX FOR INEVITABLE MISCARRIAGE , 1957 .