Antibiotics and indomethacin as perioperative management for cerclage: A systematic review and meta-analysis.

Autor: Delatorre E; Department of Medicine, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil. Electronic address: draericadelatorre@gmail.com., Provinciatto H; Department of Medicine, Barão de Mauá University Center, Ribeirão Preto, SP, Brazil. Electronic address: henriquegprovinciatto@gmail.com., Rolo LC; Department of Obstetrics, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil. Electronic address: liliamrolo@hotmail.com., Araujo Júnior E; Department of Obstetrics, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil; Discipline of Woman Health, Municipal University of São Caetano do Sul (USCS), São Caetano do Sul-SP, Brazil. Electronic address: araujojred@terra.com.br.
Jazyk: angličtina
Zdroj: European journal of obstetrics, gynecology, and reproductive biology [Eur J Obstet Gynecol Reprod Biol] 2025 Jan; Vol. 304, pp. 104-108. Date of Electronic Publication: 2024 Nov 26.
DOI: 10.1016/j.ejogrb.2024.11.036
Abstrakt: Objective: Prematurity complications remain the leading cause of perinatal morbidity and mortality. Although cerclage shows promise in preventing preterm birth, it remains unclear whether perioperative management, such as the use of antibiotics or indomethacin, offers any additional benefit.
Study Desing: We conducted a systematic review and random-effects meta-analysis comparing the use of indomethacin, antibiotics, and their combination as perioperative management for cerclage versus cerclage alone. Our research protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) on June 9, 2024 (ID CRD42024552516).
Results: Our systematic review encompassed ten studies, and 838 pregnant women submitted to cerclage for prevention of preterm birth. We found no association between perioperative management and preterm birth before 28 weeks (RR 1.03; 95 % CI 0.76-1.39; p = 0.86), or perinatal mortality (RR 0.81; 95 % CI 0.54-1.22; p = 0.32).
Conclusion: Antibiotics, indomethacin, and their combination may have no additional benefit to cerclage in risk reduction of preterm birth or perinatal mortality.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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