Document Detail

Prior cerclage: to repeat or not to repeat? That is the question.
MedLine Citation:
PMID:  18546079     Owner:  NLM     Status:  MEDLINE    
Our objective was to compare obstetrical outcomes of women with a prior cerclage for nontraditional indications who in the subsequent pregnancy either received a history-indicated cerclage or were followed by transvaginal ultrasound (TVU) cervical length (CL). All women with a history- or ultrasound- indicated cerclage in a prior pregnancy and who had a subsequent pregnancy were retrospectively identified from a preexisting database of women at risk for preterm birth between 1995 and 2002. Only women who reached >or= 12 weeks of gestation were included for analysis. Women with a diagnosis other than classic cervical insufficiency were managed in the subsequent pregnancy either by history-indicated cerclage or by serial TVU CL. The primary outcome was spontaneous preterm birth < 35 weeks. We identified 56 women with a prior cerclage for nontraditional indications. In the subsequent pregnancy, 28 women were followed with TVU and 28 matched controls received history-indicated cerclage. The groups were matched for demographics and risk factors. There were no differences between the two groups in the incidence of preterm labor < 35 weeks (21% versus 11%; P = 0.5), preterm premature rupture membranes < 35 weeks (7% versus 11%; P = 1.0), spontaneous preterm birth < 35 weeks (11% versus 11%; P = 1.0), or the gestational age at delivery (36.3 +/- 6.6 versus 36.5 +/- 5.6; P = 0.5). We concluded that in women with prior cerclage for indications other than classic cervical insufficiency, repeat history-indicated cerclage may not improve outcome compared with management with TVU CL follow-up.
Jacquelyn J Pelham; Dawnette Lewis; Vincenzo Berghella
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Publication Detail:
Type:  Journal Article     Date:  2008-06-10
Journal Detail:
Title:  American journal of perinatology     Volume:  25     ISSN:  1098-8785     ISO Abbreviation:  Am J Perinatol     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-09-29     Completed Date:  2009-01-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8405212     Medline TA:  Am J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  417-20     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Washington Hospital Center, Washington, District of Columbia 20010, USA.
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MeSH Terms
Cerclage, Cervical / adverse effects*,  methods*
Fetal Membranes, Premature Rupture / etiology
Gestational Age
Obstetric Labor, Premature / etiology
Premature Birth / etiology
Retrospective Studies
Risk Factors
Ultrasonography, Prenatal
Uterine Cervical Incompetence / surgery,  ultrasonography
Young Adult

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