Document Detail


Cervical incompetence prevention randomized cerclage trial: emergency cerclage with bed rest versus bed rest alone.
MedLine Citation:
PMID:  14586323     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this study was to compare preterm delivery rates and neonatal morbidity/mortality rates for women with cervical incompetence with membranes at or beyond a dilated external cervical os that was treated with emergency cerclage, bed rest plus indomethacin, versus just bed rest. STUDY DESIGN: Women with cervical incompetence with membranes at or beyond a dilated external cervical os, before 27 weeks of gestation, were treated with antibiotics and bed rest and randomly assigned for emergency cerclage and indomethacin or bed rest only. RESULTS: Twenty-three women were included; 13 women were allocated randomly to the emergency cerclage and indomethacin group, and 10 women were allocated randomly to the bed rest-only group. Gestational age at time of randomization was 22.2 weeks in the emergency cerclage and indomethacin group and 23.0 weeks in the bed rest-only group. Mean interval from randomization until delivery was 54 days in the emergency cerclage and indomethacin group and 20 days in the bed rest-only group (P=.046). Mean gestational age at delivery was 29.9 weeks in the emergency cerclage and indomethacin group and 25.9 weeks in the bed rest-only group. Preterm delivery before 34 weeks of gestation was significantly lower in the emergency cerclage and indomethacin group, with 7 of 13 deliveries versus all 10 deliveries in the bed rest-only group (P=.02). CONCLUSIONS: Emergency cerclage, indomethacin, antibiotics, and bed rest reduce preterm delivery before 34 weeks compared with bed rest and antibiotics alone.
Authors:
Sietske M Althuisius; Gustaaf A Dekker; Pieter Hummel; Herman P van Geijn;
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  189     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-30     Completed Date:  2003-12-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  907-10     Citation Subset:  AIM; IM    
Affiliation:
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / therapeutic use
Bed Rest*
Cerclage, Cervical*
Emergencies
Female
Gestational Age
Humans
Indomethacin / therapeutic use
Pregnancy
Tocolytic Agents / therapeutic use
Uterine Cervical Incompetence / therapy*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Tocolytic Agents; 53-86-1/Indomethacin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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