Effectiveness of cervical cerclage on pregnancy outcomes in pregnant women with the history of preterm labor
Student Research in Translational Medicine,
Vol. 4 (2022),
28 November 2022
https://doi.org/10.22037/smsj.v4i1.35873
Abstract
Aim: We aimed to investigate the effectiveness of Cerclage in the pregnancy outcome based on the obstetric history and find out how the timing of the cerclage insertion could improve the pregnancy outcomes.
Method: We conducted a retrospective descriptive study that enrolled 210 women who underwent history-indicated Cerclage. In all the women, McDonald's method was performed. Demographic data and delivery history were retired from the informative hospital system (HIS). The pregnancies were divided into two groups, low-risk group defined as pregnant women with a history of preterm labor (PTL) or second-trimester loss (STL) ≤ 2, and a high-risk group referred to patients with a history of preterm labor or second-trimester loss (STL) ≥3, to compare the efficacy and timing of the Cerclage in both groups. The Pearson Chi-squared test, student t-test, and ANOVA test were performed by SPSS 26.0. p-value<0.05 was statistically significant
Result: of 210 women enrolled in the study, 158 were low-risk. Our results show that the obstetric history and cerclage-related factors shortened the gestational age at cerclage insertion and delivery (p-value<0.05). Earlier cerclage insertion prevented preterm labor and improved neonatal outcomes. However, the time of cerclage insertion was later in the low-risk group, and the gestational age of the low-risk group was statistically significantly longer than the high-risk group (36.61±2 weeks in the low-risk group versus 35±2.14 weeks' gestation in the high-risk group) (p-value<0.001). Women in the high-risk group were significantly more likely to deliver a newborn with low birth weight or be admitted to the NICU ward.
Conclusion: Cerclage improved pregnancy and neonatal outcomes. The elective Cerclage was more effective in the low-risk group than the high-risk group.
- Cervical cerclage
- Preterm labor
- Neonatal outcome
How to Cite
References
2. Althuisius SM, Dekker GA, Hummel P, Bekedam DJ, van Geijn HP. Final results of the Cervical Incompetence Prevention Randomized Cerclage Trial (CIPRACT): therapeutic cerclage with bed rest versus bed rest alone. Am J Obstet Gynecol. 2001;185(5):1106-12.
3. Chen Q, Chen G, Li N. Clinical effect of emergency cervical cerclage and elective cervical cerclage on pregnancy outcome in the cervical-incompetent pregnant women. Arch Gynecol Obstet. 2018;297(2):401-7.
4. Cho GJ, Ouh YT, Kim LY, Lee TS, Park GU, Ahn KH, et al. Cerclage is associated with the increased risk of preterm birth in women who had cervical conization. BMC Pregnancy Childbirth. 2018;18(1):277.
5. Ciavattini A, Delli Carpini G, Boscarato V, Febi T, Di Giuseppe J, Landi B. Effectiveness of emergency cerclage in cervical insufficiency. J Matern Fetal Neonatal Med. 2016;29(13):2088-92.
6. Conde-Agudelo A, Romero R, Da Fonseca E, O'Brien JM, Cetingoz E, Creasy GW, et al. Vaginal progesterone is as effective as cervical cerclage to prevent preterm birth in women with a singleton gestation, previous spontaneous preterm birth, and a short cervix: updated indirect comparison meta-analysis. Am J Obstet Gynecol. 2018;219(1):10-25.
7. Derakhshi B, Esmailnasab N, Ghaderi E, Hemmatpour S. Risk factor of preterm labor in the west of iran: a case-control study. Iran J Public Health. 2014;43(4):499-506.
8. Ehsanipoor RM, Seligman NS, Saccone G, Szymanski LM, Wissinger C, Werner EF, et al. Physical Examination-Indicated Cerclage: A Systematic Review and Meta-analysis. Obstet Gynecol. 2015;126(1):125-35.
9. Eichenwald EC, Stark AR. Management and outcomes of very low birth weight. N Engl J Med. 2008;358(16):1700-11.
10. Frey HA, Klebanoff MA. The epidemiology, etiology, and costs of preterm birth. Semin Fetal Neonatal Med. 2016;21(2):68-73.
11. Hamta A, Kazemnejad A, Gholami Fesharaki M, Farhadi R. Effectiveness of Cervical Cerclage on Preterm Delivery and Neonatal Outcome in Twin Pregnancies: Propensity Score Matching Analysis. Iranian Red Crescent Medical Journal. 2016;19(5).
12. Harger JH. Cerclage and cervical insufficiency: an evidence-based analysis. Obstet Gynecol. 2002;100(6):1313-27.
13. Karahasanoğlu A, Uzun Çilingir I, Deregözü A, Akin H, Hocagil Z, Yücel O. Cervical cerclage complications: eight years of experience. Perinatal Journal. 2014;22(2):99-104.
14. Liu Y, Ke Z, Liao W, Chen H, Wei S, Lai X, et al. Pregnancy outcomes and superiorities of prophylactic cervical cerclage and therapeutic cervical cerclage in cervical insufficiency pregnant women. Arch Gynecol Obstet. 2018;297(6):1503-8.
15. Parilla BV, Haney EI, MacGregor SN. The prevalence and timing of cervical cerclage placement in multiple gestations. Int J Gynaecol Obstet. 2003;80(2):123-7.
16. Simcox R, Shennan A. Cervical cerclage: a review. Int J Surg. 2007;5(3):205-9.
17. Vasudeva N, Reddington C, Bogdanska M, De Luca L. Emergency versus Elective Cervical Cerclage: An Audit of Our First Two Years of Service. Biomed Res Int. 2018;2018:2065232.
18. Vogel JP, Chawanpaiboon S, Moller AB, Watananirun K, Bonet M, Lumbiganon P. The global epidemiology of preterm birth. Best Pract Res Clin Obstet Gynaecol. 2018;52:3-12.
19. Yakoob NK, Jamal SM, Tektook NK. Pregnancy Outcome after Cervical Cerclage. Research Journal of Pharmacy and Technology. 2019;12(10).
20. Zakkia K RK, Anwar Khan W. Success Rate of Cervical Cerclage in Preventing Preterm Labour. J Preg Child Health. 2015;2(176).
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