Document Detail


Routine cervical cerclage in higher order multiple gestation -- does it prolong the pregnancy?
MedLine Citation:
PMID:  11931683     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Preterm birth following cervical dilatation is the greatest threat to infants of a multiple pregnancy. Lacking reliable data concerning the effect of prophylactic cerclage, we compared a study group to controls for maternal and perinatal outcome. Sixteen of 94 triplet-, 9 of 18 quadruplet/quintuplet-pregnancies, treated with prophylactic cerclage, were retrospectively compared to those without cervical cerclage respectively. Kruskal-Wallis test and Mann-Whitney-U test were performed as non-parametric one way analysis of variance. For the analysis of frequencies Chi Square test or Fisher's exact test were performed. Odds ratio with 95% confidence interval was used to compare the need for intravenous tocolysis as well as perinatal morbidity and mortality. Gestational age at delivery was not different from the controls in all studied groups. Birth weight revealed a 200 g dominance for the "no cerclage-triplets", while this significant difference was inverted for quadruplets/quintuplets (1245 g vs. 1069 g). With respect to gestational age at birth, need for hospitalisation or medical intervention no benefit was achieved. Moreover, perinatal outcome analysed by arterial pH, APGAR-Score and perinatal mortality was not altered by a prophylactic cerclage. Perinatal morbidity for quadruplets and quintuplets was even higher in cerclage pregnancies. Therefore, these retrospective results disclaim a positive impact of cervical cerclage on pregnancy management or perinatal outcome in multifetal pregnancies.
Authors:
Alexander Strauss; Ivo M Heer; Udo Janssen; Christian Dannecker; Peter Hillemanns; Susanne Müller-Egloff
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Twin research : the official journal of the International Society for Twin Studies     Volume:  5     ISSN:  1369-0523     ISO Abbreviation:  Twin Res     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-04-04     Completed Date:  2002-08-15     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  9815819     Medline TA:  Twin Res     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  67-70     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology - Grosshadern, University of Munich, Germany. Alexander.Strauss@helios.med.uni-muechen.de
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MeSH Terms
Descriptor/Qualifier:
Apgar Score
Cerclage, Cervical*
Female
Gestational Age
Humans
Infant
Infant Mortality
Infant, Low Birth Weight
Infant, Newborn
Obstetric Labor, Premature / prevention & control*
Odds Ratio
Pregnancy
Pregnancy Outcome
Pregnancy, Multiple* / physiology
Quadruplets
Quintuplets
Retrospective Studies
Triplets

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


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