| A randomized trial of cerclage vs. 17 alpha-hydroxyprogesterone caproate for treatment of short cervix. | |
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MedLine Citation:
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PMID: 19492920 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine pregnancy outcome in patients with short cervix on transvaginal ultrasound between 16 and 24 weeks' gestation treated with McDonald cerclage compared to weekly intramuscular injections of 17 alpha-hydroxyprogesterone caproate (17OHP-C). METHODS: From November 2003 through December 2006, asymptomatic, singleton pregnancies were screened with transvaginal ultrasound between 16-24 weeks' gestation. Patients with a cervical length (CL) < or =25 mm were offered enrollment. Patients were randomly assigned to treatment with McDonald cerclage or weekly intramuscular injections of 17OHP-C. The primary outcome was spontaneous preterm birth (PTB) prior to 35 weeks' gestation. RESULTS: Seventy-nine patients met inclusion criteria; 42 were randomly assigned to the cerclage and 37 to 17OHP-C. Spontaneous PTB prior to 35 weeks' gestation occurred in 16/42 (38.1%) of the cerclage group and in 16/37 (43.2%) of the 17OHP-C group (relative risk, 1.14 95% CI, 0.67, 1.93). A post hoc analysis of patients with a prior PTB showed no difference in spontaneous PTB <35 weeks between groups. A similar analysis of patients with a CL< or =15 mm showed a reduction in spontaneous PTB <35 weeks in the cerclage group (relative risk 0.48, 0.24-0.97). CONCLUSION: Women with CL < or =25 mm in the second-trimester appear to have similar risks of delivering prior to 35 weeks' gestation when treated with 17OHP-C or McDonald cerclage. However, cerclage may be more effective in preventing spontaneous PTB in women with CL< or =15 mm. |
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Authors:
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Sean M Keeler; Daniel Kiefer; Meredith Rochon; Joanne N Quinones; Akiva P Novetsky; Orion Rust |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Journal of perinatal medicine Volume: 37 ISSN: 1619-3997 ISO Abbreviation: J Perinat Med Publication Date: 2009 |
Date Detail:
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Created Date: 2009-09-03 Completed Date: 2010-02-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0361031 Medline TA: J Perinat Med Country: Germany |
Other Details:
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Languages: eng Pagination: 473-9 Citation Subset: IM |
Affiliation:
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Obstetrics and Gynecology, Lehigh Valley Health Network, Allentown, PA 18103, USA. sean.keeler@gmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cerclage, Cervical* Cervical Length Measurement Female Humans Hydroxyprogesterones / administration & dosage, therapeutic use* Infant, Newborn Injections, Intramuscular Obstetric Labor, Premature / prevention & control Pregnancy Pregnancy Outcome Pregnancy Trimester, Second Risk Factors Uterine Cervical Incompetence / drug therapy*, surgery*, ultrasonography Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Hydroxyprogesterones; 630-56-8/17-alpha-hydroxy-progesterone caproate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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