We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Cervical cerclage for preterm birth prevention in twin gestation with short cervix: a retrospective cohort study.
- Authors
Houlihan, C.; Poon, L. C. Y.; Ciarlo, M.; Kim, E.; Guzman, E. R.; Nicolaides, K. H.
- Abstract
<bold>Objective: </bold>To determine if cervical cerclage reduces the rate of spontaneous early preterm birth in cases of dichorionic-diamniotic (DCDA) twin gestation with an ultrasound-detected short cervix.<bold>Methods: </bold>This was a retrospective cohort study of 40 consecutive DCDA twin gestations at Saint Peter's University Hospital from November 2006 to November 2014 in which cervical cerclage was performed for an ultrasound-determined cervical length of 1-24 mm at 16-24 weeks' gestation. The cases were matched with 40 controls without cerclage for cervical length and gestational age at cervical assessment. The primary outcome measure was spontaneous birth < 32 weeks.<bold>Results: </bold>There was no difference between the two groups in maternal age, body mass index (BMI), cigarette smoking, use of in-vitro fertilization (IVF), parity and prior spontaneous preterm birth. There were more Caucasian women among the controls compared with cases. In the cases, compared with controls, spontaneous delivery < 32 weeks was significantly less frequent (20.0% vs 50.0%; relative risk, 0.40 (95% CI, 0.20-0.80)). In the prediction of spontaneous delivery < 32 weeks, logistic regression analysis demonstrated that the risk was reduced with the insertion of cervical cerclage (odds ratio, 0.22 (95% CI, 0.058-0.835); P = 0.026), corrected for maternal age, BMI, racial origin, cigarette smoking, IVF, parity and previous preterm birth.<bold>Conclusion: </bold>In DCDA twin gestation with a short cervix, treatment with cervical cerclage may reduce the rate of early preterm birth. The findings suggest the need for adequate randomized controlled trials on cerclage in twin gestations with a short cervix. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
- Subjects
CERVICAL cerclage; PREMATURE labor; COHORT analysis; GESTATIONAL age; BODY mass index; HUMAN in vitro fertilization; PREMATURE infants; CERVIX uteri; FETAL ultrasonic imaging; MATERNAL age; MENTAL health surveys; MULTIPLE pregnancy; QUESTIONNAIRES; RETROSPECTIVE studies; PREVENTION
- Publication
Ultrasound in Obstetrics & Gynecology, 2016, Vol 48, Issue 6, p752
- ISSN
0960-7692
- Publication type
journal article
- DOI
10.1002/uog.15918