Document Detail


The prevalence and timing of cervical cerclage placement in multiple gestations.
MedLine Citation:
PMID:  12566184     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To investigate the prevalence and timing of cervical cerclage placement in multiple gestations. METHODS: Our perinatal database was queried for all multiple gestations delivered at Evanston Hospital from 12/95 through 12/00. This list was then cross-matched with billing and medical records for 'incompetent cervix' and 'cerclage.' The medical records of all deliveries </=26 weeks were reviewed in order to ascertain if cervical incompetence was responsible for the preterm delivery. RESULTS: There were 802 deliveries of multiple gestations >/=14 weeks over a 5-year period. The number of patients that underwent cerclage placement was 29 or 3.6%. The mean gestational age at cerclage placement was 18.6+/-4.5 weeks (range 11-24.6). Twelve were elective or prophylactic while 17 were 'urgent' or 'emergent.' The mean gestational age for the 17 emergent cerclages was 21.4+/-2.2 weeks (range 16.6-24.6). When compared with those patients who did not undergo cerclage placement, there was no difference in maternal demographics including age, parity, or previous full-term delivery. There was a significant difference in the gestational age at delivery for the cerclage vs. no cerclage group; 29.3+/-5.6 vs. 34.4+/-4.6 weeks, respectively, and in the frequency of losses at </=26 weeks; 8/23 (38%) vs. 48/707 (6.8%), P<0.001. Ten of the losses in the no cerclage group appeared consistent with incompetent cervix for a total of 39/802 or 4.9% rate of cervical incompetence in our multiple gestation population. CONCLUSIONS: The relatively low prevalence of cervical incompetence in our multiple gestations does not justify prophylactic cervical cerclage placement. Expectant management with serial cervical examinations starting at 16-18 weeks appears more prudent.
Authors:
B V Parilla; E I Haney; S N MacGregor
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics     Volume:  80     ISSN:  0020-7292     ISO Abbreviation:  Int J Gynaecol Obstet     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-02-04     Completed Date:  2003-06-02     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0210174     Medline TA:  Int J Gynaecol Obstet     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  123-7     Citation Subset:  IM    
Affiliation:
Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Evanston-Northwestern Healthcare, Northwestern University Medical School, Evanston, IL, USA. bparilla@enh.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Cerclage, Cervical / statistics & numerical data*
Female
Gestational Age
Humans
Illinois / epidemiology
Pregnancy
Pregnancy, Multiple* / statistics & numerical data
Prevalence
Retrospective Studies
Uterine Cervical Incompetence / epidemiology*

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


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