Document Detail

Cerclage for short cervix on ultrasonography in women with singleton gestations and previous preterm birth: a meta-analysis.
MedLine Citation:
PMID:  21446209     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To estimate if cerclage prevents preterm birth and perinatal mortality and morbidity in women with previous preterm birth, singleton gestation, and short cervical length in a meta-analysis of randomized trials.
DATA SOURCES: MEDLINE, PUBMED, EMBASE, and the Cochrane Library were searched using the terms "cerclage," "short cervix," "ultrasound," and "randomized trial."
METHODS OF STUDY SELECTION: We included randomized trials of cerclage in women with short cervical length on transvaginal ultrasonography, limiting the analysis to women with previous spontaneous preterm birth and singleton gestation.
TABULATION, INTEGRATION, AND RESULTS: Patient-level data abstraction and analysis were accomplished by two independent investigators. Five trials met inclusion criteria. In women with a singleton gestation, previous spontaneous preterm birth, and cervical length less than 25 mm before 24 weeks of gestation, preterm birth before 35 weeks of gestation was 28.4% (71/250) in the cerclage compared with 41.3% (105/254) in the no cerclage groups (relative risk 0.70, 95% confidence interval 0.55– 0.89). Cerclage also significantly reduced preterm birth before 37, 32, 28, and 24 weeks of gestation. Composite perinatal mortality and morbidity were significantly reduced (15.6% in cerclage compared with 24.8% in no cerclage groups; relative risk 0.64, 95% confidence interval 0.45– 0.91).
CONCLUSION: In women with previous spontaneous preterm birth, singleton gestation, and cervical length less than 25 mm, cerclage significantly prevents preterm birth and composite perinatal mortality and morbidity.
Vincenzo Berghella; Timothy J Rafael; Jeff M Szychowski; Orion A Rust; John Owen
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Publication Detail:
Type:  Journal Article; Meta-Analysis    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  117     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-29     Completed Date:  2011-04-12     Revised Date:  2011-05-09    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  663-71     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
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MeSH Terms
Cerclage, Cervical*
Cervix Uteri / ultrasonography
Pregnancy Trimester, Second
Premature Birth / prevention & control*
Randomized Controlled Trials as Topic
Recurrence / prevention & control

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