Cervical lacerations in planned versus labor cerclage removal: a systematic review.

Autor: Simonazzi G; Department of Medical Surgical Sciences, Division of Obstetrics and Prenatal Medicine, St. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy., Curti A; Department of Medical Surgical Sciences, Division of Obstetrics and Prenatal Medicine, St. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy., Bisulli M; Department of Medical Surgical Sciences, Division of Obstetrics and Prenatal Medicine, St. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy., Seravalli V; Department of Gynecology and Obstetrics, The Johns Hopkins Hospital, Baltimore, MD, USA., Saccone G; Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy., Berghella V; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: Vincenzo.berghella@jefferson.edu.
Jazyk: angličtina
Zdroj: European journal of obstetrics, gynecology, and reproductive biology [Eur J Obstet Gynecol Reprod Biol] 2015 Oct; Vol. 193, pp. 19-22. Date of Electronic Publication: 2015 Jul 09.
DOI: 10.1016/j.ejogrb.2015.06.032
Abstrakt: Objective: The aim of this study was to evaluate the incidence of cervical lacerations with cerclage removal planned before labor compared to after the onset of labor by a systematic review of published studies.
Study Design: Searches were performed in electronic databases from inception of each database to November 2014. We identified all studies reporting the rate of cervical lacerations and the timing of cerclage removal (either before or after the onset of labor). The primary outcome was the incidence of spontaneous and clinically significant intrapartum cervical lacerations (i.e. lacerations requiring suturing).
Results: Six studies, which met the inclusion criteria, were included in the analysis. The overall incidence of cervical lacerations was 8.9% (32/359). There were 23/280 (6.4%) cervical lacerations in the planned removal group, and 9/79 (11.4%) in the removal after labor group (odds ratio 0.70, 95% confidence interval 0.31-1.57).
Conclusions: In summary, planned removal of cerclage before labor was not shown to be associated with statistically significant reduction in the incidence of cervical lacerations. However, since that our data probably did not reach statistical significance because of a type II error, further studies are needed.
(Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)
Databáze: MEDLINE
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