Therapeutic cerclage may be more efficacious in women who develop cervical insufficiency after a term delivery

Poggi, Sarah; Vyas, Nisha; Pezzullo, John C.; Landy, Helain J.; Ghidini, Alessandro

doi:10.1016/j.ajog.2008.08.005

Cited by 10 publications

(15 citation statements)

References 13 publications

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“…Nulliparity is reportedly associated with delivery before 28 weeks and women with a prior term delivery are significantly more likely to deliver after 35 weeks (90% vs 48%) than women with no prior term delivery . Several studies have reported that women with rescue cerclage are more likely to deliver before 28 weeks of gestation, more so when cervical dilatation is ≥ 2 cm at the time of the procedure with bulging membranes prolapsing beyond the external os .…”

Section: Discussionmentioning

confidence: 99%

Outcomes of pregnancy in women who had rescue cerclage for cervical insufficiency: A single‐center retrospective study

Gundabattula

Marakani

Dasari

et al. 2013

J of Obstet and Gynaecol

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Section: Discussionmentioning

confidence: 99%

Outcomes of pregnancy in women who had rescue cerclage for cervical insufficiency: A single‐center retrospective study

Gundabattula

Marakani

Dasari

et al. 2013

J of Obstet and Gynaecol

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“…In particular, the aforementioned study comprised a heterogeneous patient group with respect to cerclage indication, plurality, and disease entity and did not include subgroup analysis, probably due to the small number of participants. 26 Thus, we believe that our findings are relevant because the participants in this study were more homogeneous with respect to gestational age at cerclage, cerclage indication, plurality, and treatment characteristics compared to those of the previous study. 26 Interestingly, we also noted that significantly elevated levels of MMP-8 and reduced kallistatin levels in the AF, all of which are ECM remodeling-related mediators, were observed in multiparous women who experienced acute CI after a term birth compared to those without a history of a prior term birth (mostly nulliparas).…”

Section: Discussionmentioning

confidence: 65%

Degree of expression of inflammatory proteins in the amniotic cavity, but not prior obstetric history, is associated with the risk severity for spontaneous preterm birth after rescue cerclage for cervical insufficiency

Park

Lee

et al. 2023

American J Rep Immunol

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ProblemTo examine whether the severity of spontaneous preterm birth (SPTB) risk after rescue cerclage for acute cervical insufficiency (CI) is linked to the degree of inflammatory response in the amniotic fluid (AF) based on the concentrations of various inflammatory proteins and prior obstetric history.Method of studyWe conducted a retrospective cohort study of 65 singleton pregnant women (17–25 weeks) who underwent rescue cerclage following the diagnosis of acute CI and were subjected to amniocentesis. EN‐RAGE, IL‐6, IL‐8, and IP‐10 as inflammatory mediators and kallistatin, MMP‐2/8, and uPA as extracellular matrix remodeling‐related molecules were assayed in the AF using ELISA. The level of each inflammatory mediator was divided into quartiles.ResultsIntra‐amniotic inflammation (IAI; AF IL‐6 level ≥2.6 ng/mL) was independently associated with SPTB after cerclage placement. The odds of SPTB at < 32 weeks, even after adjusting for confounders, increased significantly with each increasing quartile of baseline AF levels for each inflammatory mediator (p for trend < .05). Kaplan‐Meier survival curves showed that the cerclage‐to‐delivery intervals were significantly shorter as the quartiles of AF EN‐RAGE and MMP‐8 increased (log‐rank test, p < .01 each). Neither previous term birth nor prior PTB was associated with SPTB risk or cerclage‐to‐delivery interval after rescue cerclage. Multiparous women who experience CI after term birth showed significantly elevated levels of MMP‐8 and reduced kallistatin levels in the AF.ConclusionIn patients with CI, SPTB risk (especially risk severity) after rescue cerclage is associated with the degree of the inflammatory response in AF as well as the presence of IAI but not with prior obstetric history.

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“…In a subset of patients with a history of preterm delivery, mid-trimester screening of cervical length and applying cervical sutures have been associated with good neonatal outcomes. 12 The data available are mixed, and that different authors have different suggestions and controversies in placing cerclage.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy Outcomes of Patients with Ultrasound-indicated and History-indicated McDonald Cervical Cerclage

Hoodbhoy¹,

Memon²,

Anjum³

2022

Journal of South Asian Federation of Obstetrics and Gynaecology

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Therapeutic cerclage may be more efficacious in women who develop cervical insufficiency after a term delivery

Cited by 10 publications

References 13 publications

Outcomes of pregnancy in women who had rescue cerclage for cervical insufficiency: A single‐center retrospective study

Outcomes of pregnancy in women who had rescue cerclage for cervical insufficiency: A single‐center retrospective study

Degree of expression of inflammatory proteins in the amniotic cavity, but not prior obstetric history, is associated with the risk severity for spontaneous preterm birth after rescue cerclage for cervical insufficiency

Pregnancy Outcomes of Patients with Ultrasound-indicated and History-indicated McDonald Cervical Cerclage

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