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- Title
Removal vs. retention of cervical cerclage in pregnancies complicated by preterm premature rupture of membranes: a retrospective study.
- Authors
Vitner, Dana; Melamed, Nir; Elhadad, David; Phang, Michael; Ram, Maya; Asztalos, Elizabeth; Zaltz, Arthur; Shah, Prakesh S.; Barrett, Jon
- Abstract
<bold>Purpose: </bold>To compare pregnancy outcomes in women with pPROM and a cervical cerclage in whom the cerclage was removed within 24 h and those in whom the cerclage was retained in situ.<bold>Methods: </bold>A two-center retrospective cohort study of women with a singleton gestation with pPROM at < 340/7 weeks of gestation in the presence of cervical cerclage (January 1, 2012-July 30, 2016). Maternal and perinatal outcomes were compared between women in whom cerclage was removed within 24 h from pPROM and those in whom cerclage was retained until the onset of delivery. The primary outcome was time from pPROM to delivery.<bold>Results: </bold>Seventy women met inclusion criteria. Cerclage was left in situ in 47 (67.1%) and removed in 23 (32.9%) women. Women in the cerclage retention group had a higher pPROM-to-delivery interval (7.0 ± 7.2 vs. 6.0 ± 10.9 days, p = 0.03), and were more likely to have a latency period > 48 h (87.2% vs. 65.2%, p = 0.03; aOR 3.9, 95% CI 3.1-4.9) or > 7 days (29.8% vs. 8.7%, p = 0.04; aOR 7.0, 95% CI 2.5-19.6) compared with women in whom cerclage was removed. Furthermore, chorioamnionitis rate was lower in the cerclage retention group compared to cerclage removal group (aOR 0.7, 95% CI 0.5-1.0). There were no differences between the groups in early neonatal sepsis, severe brain injury, or composite neonatal outcome.<bold>Conclusion: </bold>In women with pPROM and cervical cerclage, retention of cerclage may be associated with a longer latency period, and a lower chorioamnionitis rate, without an associated increase in the risk of neonatal infectious morbidity. Presentation information: The abstract of this study was presented as a poster at the 38th SMFM (Society of Maternal and Fetal Medicine) annual meeting, February 2018, Dallas, Texas, USA.
- Subjects
DALLAS (Tex.); ONTARIO; CERVICAL cerclage; CHORIOAMNIONITIS; OBSTETRICS; PREMATURE rupture of fetal membranes; NEONATAL sepsis; PREGNANCY; RETROSPECTIVE studies; CERVIX uteri surgery; PREGNANCY outcomes; FETAL diseases; SEPSIS; PREGNANCY complications; PREMATURE labor
- Publication
Archives of Gynecology & Obstetrics, 2020, Vol 302, Issue 3, p603
- ISSN
0932-0067
- Publication type
journal article
- DOI
10.1007/s00404-020-05642-y