The impact of cerclage placement on gestational length in women with premature cervical shortening.
| Autor: | Borochov Hausner, Noga, Baumfeld, Yael, Yaniv-Salem, Shimrit, Hamou, Batel, Silberstein, Tali |
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| Předmět: |
UTERINE cervix incompetence treatment
CONSERVATIVE treatment PROGESTERONE PREMATURE infants ACADEMIC medical centers BED rest RETROSPECTIVE studies MANN Whitney U Test GESTATIONAL age PREGNANCY outcomes TREATMENT effectiveness INTRAMUSCULAR injections T-test (Statistics) FETAL diseases BIRTH weight INTRAVAGINAL administration CHI-squared test DESCRIPTIVE statistics OBSTETRICAL emergencies DATA analysis software APGAR score LOGISTIC regression analysis ODDS ratio CERVICAL cerclage LONGITUDINAL method |
| Zdroj: | Journal of Perinatal Medicine; Jul2023, Vol. 51 Issue 6, p782-786, 5p |
| Abstrakt: | Cervical insufficiency (CI) is a condition consistent with painless cervical dilatation that can lead to preterm delivery. Cervical cerclage is a procedure in which cervical suture is performed for preventing preterm labor in several indications. Late emergency cerclage is technically more challenging compared to elective cerclage, performed earlier during pregnancy, prior to cervical changes. Pregnancy outcomes with emergency cerclage were found to be improved in previous reports, but there is still inconclusive data. To assess the effectiveness and safety of emergency cerclage vs. conservative management with progesterone and/or bed resting, in preventing preterm birth and improving neonatal outcomes in women with clinically evident cervical insufficiency. This is a retrospective cohort study conducted on all women diagnosed with cervical insufficiency between the 16th and 24th gestational week who met the inclusion criteria, from January 2012 to December 2018. Obstetric and neonatal outcomes: time from diagnosis to delivery, duration of pregnancy, birth weight and Apgar score, were compared between women who underwent cerclage and those who treated conservatively. Twenty eight women underwent emergency cerclage (cerclage group) and 194 managed with a conservative therapy, progesterone and/or bed rest (control group). Time from diagnosis to delivery 13 weeks vs. 8 weeks and birth weight 2,418 g vs. 1914 g were significantly higher in the first cohort. Average pregnancy duration was three weeks longer in the cerclage group, but that was not significant. No complications occurred in the cerclage group and no difference in mode of delivery were found. Emergency cerclage is an effective and safe procedure in preventing preterm birth and prolongation of pregnancy, in women with cervical insufficiency in the late second trimester. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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