Document Detail


Multicenter randomized trial of cerclage for preterm birth prevention in high-risk women with shortened midtrimester cervical length.
MedLine Citation:
PMID:  19788970     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of the study was to assess cerclage to prevent recurrent preterm birth in women with short cervix.
STUDY DESIGN: Women with prior spontaneous preterm birth less than 34 weeks were screened for short cervix and randomly assigned to cerclage if cervical length was less than 25 mm.
RESULTS: Of 1014 women screened, 302 were randomized; 42% of women not assigned and 32% of those assigned to cerclage delivered less than 35 weeks (P = .09). In planned analyses, birth less than 24 weeks (P = .03) and perinatal mortality (P = .046) were less frequent in the cerclage group. There was a significant interaction between cervical length and cerclage. Birth less than 35 weeks (P = .006) was reduced in the less than 15 mm stratum with a null effect in the 15-24 mm stratum.
CONCLUSION: In women with a prior spontaneous preterm birth less than 34 weeks and cervical length less than 25 mm, cerclage reduced previable birth and perinatal mortality but did not prevent birth less than 35 weeks, unless cervical length was less than 15 mm.
Authors:
John Owen; Gary Hankins; Jay D Iams; Vincenzo Berghella; Jeanne S Sheffield; Annette Perez-Delboy; Robert S Egerman; Deborah A Wing; Mark Tomlinson; Richard Silver; Susan M Ramin; Edwin R Guzman; Michael Gordon; Helen Y How; Eric J Knudtson; Jeff M Szychowski; Suzanne Cliver; John C Hauth
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  201     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-30     Completed Date:  2009-10-22     Revised Date:  2010-12-03    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  375.e1-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL 35249-7333, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cerclage, Cervical*
Cervix Uteri / pathology*,  ultrasonography
Female
Humans
Logistic Models
Pregnancy
Pregnancy Outcome
Pregnancy Trimester, Second
Premature Birth / prevention & control*
Recurrence / prevention & control
Ultrasonography, Prenatal
Young Adult
Grant Support
ID/Acronym/Agency:
5K24 HD43314-5/HD/NICHD NIH HHS; K24 HD043314-05/HD/NICHD NIH HHS; U01 HD039939-05/HD/NICHD NIH HHS; U01 HD039939-05/HD/NICHD NIH HHS

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


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