Cerclage is associated with the increased risk of preterm birth in women who had cervical conization

Abstract

BackgroundThe aim of this study was to determine the effect of cerclage in women who underwent cervical conization.MethodsStudy data were collected from the Korea National Health Insurance Claims Database of the Health Insurance Review and Assessment Service for 2009–2013. Women who had a conization in 2009 and a subsequent first delivery between 2009 and 2013 in Korea were enrolled.ResultsAmong the women who had conization in 2009, 1075 women had their first delivery between 2009 and 2013. A cerclage was placed in 161 of the women who were treated by conization. The rate of preterm birth was higher in the women who were treated with cerclage following a conization compared with those without cerclage (10.56 vs 4.27, p < 0.01, respectively). The multivariate regression analysis revealed that the women who were treated cerclage following a conization had an increased risk of preterm delivery compared with women without cerclage (odds ratio (OR), 2.6, 95% confidence interval (CI), 1.4–4.9).ConclusionOur study showed that cerclage associated with an increased risk of preterm birth and preterm premature rupture of membranes in women who underwent conization. Further studies are required to clarify the mechanism by which cerclage affects the risk of preterm birth.

Analysis of pathological and clinical characteristics of cervical conization according to age group in Japan

“…Cho et al. reported that women who have undergone conization and cerclage are at higher risk of preterm birth than those who have not undergone cerclage [ 41 ]. The authors proposed that the higher risk may be attributable to inflammation after cervical cerclage and repeated trauma induced by conization.…”

“…Moreover, although the rates of preterm birth tended to be higher in women who had undergone cerclage following conization than in those who had not undergone cerclage in all age groups, these differences were not statistically significant. Cho et al reported that women who have undergone conization and cerclage are at higher risk of preterm birth than those who have not undergone cerclage [41]. The authors proposed that the higher risk may be attributable to inflammation after cervical cerclage and repeated trauma induced by conization.…”

Can prophylactic transvaginal cervical cerclage improve pregnancy outcome in patients receiving cervical conization? A meta-analysis

“…After first-circle database searching, 261 articles were detected. Following reading and screening, we accepted nine studies to be included in our final metaanalysis [7][8][9][10][11][12][13][14][15]. Figure 1 illustrated the literature screening process.…”

Prophylactic Cerclage to Prevent Preterm Birth after Conization: A Cohort Study Using Data from the National Health Insurance Service of Korea

“… 10 However, those studies suffered from a small number of subjects. To overcome the limitation of small sample sizes, Cho, et al 11 used the claims database of the National Health Insurance Service (NHIS) of Korea to look at the risk of preterm birth after conization. 11 In the report, they included more than 1000 subjects and found that the cerclage is associated with an increased risk of preterm birth in women who have undergone conization.…”

“…To overcome the limitation of small sample sizes, Cho, et al 11 used the claims database of the National Health Insurance Service (NHIS) of Korea to look at the risk of preterm birth after conization. 11 In the report, they included more than 1000 subjects and found that the cerclage is associated with an increased risk of preterm birth in women who have undergone conization. However, the timing of the procedure may matter because if the cerclage was performed when they had symptoms of cervical insufficiency, such as cervical dilatation and bulging membranes, an increased risk of preterm birth may have already been present.…”