Effectiveness of elective cervical cerclage according to obstetric history

Korb, Diane; Marzouk, Paul; Deu, Juliette; Oury, Jean‐François; Sibony, Olivier

doi:10.1016/j.jgyn.2016.09.006

Cited by 7 publications

(4 citation statements)

References 26 publications

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“…In a study conducted by Krispin et al in 2019, they evaluated the cerclage results according to their indications and stated that the fetal complications that may occur due to preterm labor were observed more frequently in patients who underwent physical examination-indicated cerclage compared to history-indicated cerclage [ 16 ]. Korb et al showed that cerclage reduces the birth rate before 24 weeks and perinatal mortality in cases with cervical shortening on ultrasound and a history of preterm birth [ 17 ]. In a meta-analysis including 15 studies, Alfirevic et al showed the positive effect of ultrasound-indicated cerclage procedure on pregnancy outcomes [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and perinatal outcomes of history-indicated, ultrasound-indicated and physical examination-indicated cerclage: a retrospective study

Gölbaşı

Bayraktar

et al. 2022

BMC Pregnancy Childbirth

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Objective To evaluate the effectiveness and perinatal outcomes of cerclage procedure according to indication. Methods The pregnancy and neonatal outcomes of the patients who underwent cerclage with the diagnosis of cervical insufficiency between January 2016 and December 2020 were retrospectively analyzed. Patients were categorized into three groups: a history-indicated group, an ultrasound-indicated group and a physical examination-indicated group. Results Seventy-three patients who underwent cerclage were included in the study. Of these, 41 (56.2%) had history-indicated, 17 (23.3%) had ultrasound-indicated and 15 (20.5%) had physical examination-indicated cerclages. Compared to history- and ultrasound-indicated cerclage group, duration from cerclage to delivery (18.6 ± 6.9 weeks vs 17.8±5.9 weeks vs 11 ± 5.3 weeks, p = 0.003) was significantly lower and delivery < 28 weeks (9.8% vs 5.9% vs 33.3%, p = 0.042) and delivery < 34 weeks of gestation (26.8% vs 11.8% vs 60%, p = 0.009) were significantly higher in physical examination-indicated cerclage group. In physical examination-indicated cerclage, compared with history- and ultrasound-indicated cerclage low birth weight, low APGAR score, neonatal intensive care unit admission and neonatal mortality were higher, although not statistically significant (p > 0.05). Conclusion Pregnant women who underwent physical examination-indicated cerclage had higher risks for preterm delivery < 28 weeks and < 34 weeks than history- and ultrasound–indicated cerclage.

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Section: Discussionmentioning

confidence: 99%

Effectiveness and perinatal outcomes of history-indicated, ultrasound-indicated and physical examination-indicated cerclage: a retrospective study

Gölbaşı

Bayraktar

et al. 2022

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

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“…Similar results were found in the literature regarding history-indicated elective cerclage, achieving prevention of second trimester loss (STL) or preterm birth (PTB) in two thirds of low-risk groups (defined by one or two prior STL or PTB or by one previous successful cerclage). [6][7][8] In this study one limitation may result from indication criteria. The indication for cerclage was at least one previous second trimester spontaneous pregnancy loss where no other cause was identified, conflicting with some recommendations were history of more pregnancy losses is required, hampering comparison.…”

Section: Discussionmentioning

confidence: 99%

History-indicated transvaginal cerclage: results from a single-centre

Gomes

Almeida

Gonçalves

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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Background: Cervical incompetence occasionally results in mid-trimester pregnancy loss, preterm labour and increased foetal morbimortality. History-indicated cerclage is proposed when obstetric history suggests cervical incompetence. The aim of this study was to evaluate the maternal-foetal outcomes following prophylactic cervical cerclage.Methods: Retrospective study reviewing data of all women undergoing transvaginal history-indicated cerclage from January 1st, 2008 to December 31th, 2017 at Centro Hospitalar Universitário do Algarve - Faro. Primary outcome: gestational age <37weeks at birth. Secondary outcomes: neonatal morbimortality and intensive care unit (NICU) admission and maternal morbidity. Data were analyzed with IBM SPSS Statistics 23.Results: A total of 12 history-indicated cerclages were performed (9 women). At first cerclage, mean maternal age, gestity, parity and live children were 27.6, 2.44, 1.11 and 0.78 (87.7% preterm), respectively. At cerclage placement, mean gestational age and cervical length were 16.1 weeks and 27.5mm. Average hospital admission was 10.7 days. In all cases McDonald technique was performed. Four hospital readmissions occurred for threatened labour. Mean gestational age at cerclage removal was 36.9 weeks (83.3% in ambulatory) and 38.9 at delivery. Average time between cerclage removal and labour was 14.5 days. Spontaneous onset of labour occurred in 75% and vaginal delivery in 83.4%. There were no reports of preterm birth, foetal admission to NICU or maternal complications. Mean number of live children after procedure was 1.58.Conclusions: Prophylactic cervical cerclage seems to improve pregnancy outcome with minimal maternal risks. However, our data suggest over inclusion of women, with unnecessary procedures, emphasizing the importance of re-evaluating inclusion criteria.

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“…It enables conservation of correct development of the fetus. Other studies that proved the accuracy of the cerclage were conducted among others by Korb [21] and Andrews [22].…”

Section: Discussionmentioning

confidence: 99%

Transvaginal Cervical Cerclage in Cervical Insufficiency: Outcomes of 77 Pregnancies: Single Institution Retrospective Study

Pszczołowska,

Logoń,

Batko

et al. 2023

SciBase Obstet Gynecol

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Background: Cervical insufficiency is a major cause of second-trimester pregnancy loss and spontaneous preterm delivery. Cervical cerclage is a surgical procedure that can be performed in an attempt to maintain the structural integrity of the cervix in order to prolong gestation and improve obstetrical outcomes. Objective: The aim of the study was to investigate the effectiveness of the transvaginal cervical cerclage (TVCs). Materials and methods: A single-institution retrospective study included 106 pregnant women (93 singleton pregnancies and 13 twin pregnancies) who underwent transvaginal cerclage between 2015 and February 2022. Data extracted included patient demographics, gestation of suture insertion, gestation at delivery, mode of delivery, pregnancy outcomes and details about the suture insertion. The main outcomes of pregnancy which were evaluated were live birth rate and gestation at delivery. Results: During the study period, 106 women underwent transvaginal cerclage between 14 and 30 weeks of gestation. Cervical cerclages were done by the McDonald (n=105) or the Shirodkar technique (n=1). Regarding the mode of the delivery, cesarean section was performed in 59 cases (77%), in 18 cases it was vaginal delivery (23%). The outcomes of 77 pregnancies (88 babies) were analyzed. The live birth rate was 97,7%, a mean gestational age at delivery of 36 weeks; the preterm birth rate at <32 weeks was 19,5%, only 1,3% women delivered before 24 weeks. Conclusion: Placement of transvaginal cerclage appears to reduce preterm delivery before 32 weeks and improve neonatal survival. It appears to be a safe and effective procedure.

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Effectiveness of elective cervical cerclage according to obstetric history

Cited by 7 publications

References 26 publications

Effectiveness and perinatal outcomes of history-indicated, ultrasound-indicated and physical examination-indicated cerclage: a retrospective study

Effectiveness and perinatal outcomes of history-indicated, ultrasound-indicated and physical examination-indicated cerclage: a retrospective study

History-indicated transvaginal cerclage: results from a single-centre

Transvaginal Cervical Cerclage in Cervical Insufficiency: Outcomes of 77 Pregnancies: Single Institution Retrospective Study

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