Document Detail


Transabdominal cerclage: can we predict who fails?
MedLine Citation:
PMID:  17437202     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine the outcome of pregnancies in women with transabdominal cerclage (TAC) and to determine whether aspects of the obstetric history predict failure. METHODS: This was a cohort study of pregnant women referred for a transabdominal cerclage between 1978 and 2004. Records were reviewed for obstetric history and maternal demographics. Predictor variables were prior pregnancy loss, prior vaginal cerclage, associated factors for TAC, and maternal age. The outcome variable was delivery of an infant beyond 24 weeks who survived the neonatal period. Outcomes were compared using Student's t-test, standard z-test, and Chi-square test. RESULTS: Eighty-eight women delivered 96 pregnancies after TAC placement. The fetal salvage rate prior to TAC was 18%, 93% after the procedure (p<0.001). Delivery beyond 37 weeks occurred in 70% of pregnancies. Maternal age, prior cerclage history, associated factors for TAC, or previous delivery of a viable infant did not predict the eight failures out of the 96 pregnancies. CONCLUSION: Women with TAC had a higher rate of successful pregnancies than prior to TAC. Neither maternal age nor prior pregnancy loss predicted failure. However with such a high success rate, we would have needed 948 women to do so. TAC is an option for women with a poor obstetric history including failed vaginal cerclage.
Authors:
Andrea L Fick; Aaron B Caughey; Julian T Parer
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  20     ISSN:  1476-7058     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-04-17     Completed Date:  2007-05-15     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  63-7     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA 52242-1080, USA. andrea-fick@uiowa.edu
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MeSH Terms
Descriptor/Qualifier:
Abortion, Spontaneous / epidemiology
Adult
Cerclage, Cervical / methods*
Cohort Studies
Female
Gestational Age
Humans
Maternal Age
Pregnancy
Pregnancy Outcome / epidemiology*
Premature Birth / epidemiology
Prognosis
Risk Factors
Treatment Failure
Uterine Cervical Incompetence / surgery*
Grant Support
ID/Acronym/Agency:
HD01262/HD/NICHD NIH HHS

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


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