Document Detail


History-indicated cerclage: practice patterns of maternal-fetal medicine specialists in the USA.
MedLine Citation:
PMID:  18651834     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: There is limited evidence supporting the effectiveness of history-indicated cerclage in preventing spontaneous pregnancy loss or preterm birth. This study was undertaken to estimate the practice patterns of maternal-fetal medicine specialists in regards to history-indicated cerclage. METHODS: We performed a mail-based survey of all SMFM specialists in the US. Subjects were asked whether they would recommend a history-indicated cerclage at 12-14 weeks in a patient whose prior pregnancy was her first pregnancy and ended in a spontaneous, painless loss at 19 weeks with no identifiable cause. RESULTS: A total of 827 (46%) of SMFM members responded of which 75% would recommend a history-indicated cerclage for this patient. Twenty-one percent would not recommend one, but would place one if desired by the patient. Only 4% would not place a history-indicated cerclage in this scenario. A total of 71% believed a history-indicated cerclage was associated with moderate or significant benefit, and 89% believed it involved minimal or no risk. Female gender, non-academic practice, practicing in the southern region and greater interval since residency training were all independently associated with the recommendation for a history-indicated cerclage. CONCLUSIONS: Despite limited level-I evidence supporting its use, a history-indicated cerclage is recommended by most maternal-fetal medicine specialists.
Authors:
Nathan S Fox; Shari E Gelber; Robin B Kalish; Stephen T Chasen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of perinatal medicine     Volume:  36     ISSN:  0300-5577     ISO Abbreviation:  J Perinat Med     Publication Date:  2008  
Date Detail:
Created Date:  2008-11-07     Completed Date:  2009-02-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0361031     Medline TA:  J Perinat Med     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  513-7     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA. nfox@mfmnyc.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Cerclage, Cervical / utilization*
Female
Humans
Male
Medical History Taking
Middle Aged
Obstetrics / statistics & numerical data*
Physician's Practice Patterns / statistics & numerical data*
Prenatal Care / methods*
Questionnaires
Risk Assessment
United States
Uterine Cervical Incompetence / diagnosis,  surgery

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


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