| Elective cerclage vs. ultrasound-indicated cerclage in high-risk pregnancies. | |
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MedLine Citation:
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PMID: 11982981 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To compare pregnancy outcome after elective vs. ultrasound-indicated cervical cerclage in women at high risk of spontaneous mid-trimester loss or early preterm birth. METHODS: This was a retrospective study comparing two management strategies in women with singleton pregnancies who had at least one previous spontaneous delivery at 16-33 weeks of gestation. One group was managed by the placement of an elective cerclage at 12-16 weeks and the other group had transvaginal ultrasound examinations of the cervix at 12-15+6, 16-19+6, and 20-23+6 weeks and cervical cerclage was carried out if the cervical length was 25 mm or less. RESULTS: A total of 90 patients were examined, including 47 that were managed expectantly and 43 treated by elective cerclage. In the expectantly managed group, 59.6% (28/47) required a cervical cerclage. We excluded from further analysis three patients who were lost to follow-up and three because of fetal death or iatrogenic preterm delivery. Miscarriage or spontaneous delivery before 34 weeks' gestation occurred in 14.6% (6/41) of the elective cerclage group, compared with 20.9% (9/43) in the expectantly managed group (chi2 = 0.219, P = 0.640). CONCLUSION: In women at increased risk of spontaneous mid-trimester or early preterm delivery, a policy of sonographic surveillance followed by cervical cerclage in those with a short cervix reduces the need for surgical intervention without significantly increasing adverse pregnancy outcome. |
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Authors:
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M S To; V Palaniappan; C Skentou; D Gibb; K H Nicolaides |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology Volume: 19 ISSN: 0960-7692 ISO Abbreviation: Ultrasound Obstet Gynecol Publication Date: 2002 May |
Date Detail:
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Created Date: 2002-05-01 Completed Date: 2002-07-03 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9108340 Medline TA: Ultrasound Obstet Gynecol Country: England |
Other Details:
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Languages: eng Pagination: 475-7 Citation Subset: IM |
Affiliation:
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Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cerclage, Cervical
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methods* Chi-Square Distribution Female Gestational Age Humans Obstetric Labor, Premature / prevention & control* Pregnancy Pregnancy Outcome* Pregnancy, High-Risk* Retrospective Studies Sensitivity and Specificity Statistics, Nonparametric Surgical Procedures, Elective Ultrasonography, Prenatal / methods Uterine Cervical Incompetence / surgery*, ultrasonography* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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