Efficacy of Prophylactic Cerclage in Women with a Single History of Mid-Trimester Pregnancy Loss with Painless Cervical Dilation: A Retrospective Cohort Study
Background: Recently, serial ultrasound assessment of cervical length has been proposed as an alternative management of history-indicated cerclage. To investigate the efficacy of prophylactic cerclage among women who had previously experienced mid-trimester pregnancy loss by compa...
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| Format: | Article |
| Language: | English |
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IMR Press
2025-01-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
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| Online Access: | https://www.imrpress.com/journal/CEOG/52/1/10.31083/CEOG26338 |
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| author | Atsuko Tezuka Hiroyuki Tsuda Yumiko Ito Tomoko Ando |
| author_facet | Atsuko Tezuka Hiroyuki Tsuda Yumiko Ito Tomoko Ando |
| author_sort | Atsuko Tezuka |
| collection | DOAJ |
| description | Background: Recently, serial ultrasound assessment of cervical length has been proposed as an alternative management of history-indicated cerclage. To investigate the efficacy of prophylactic cerclage among women who had previously experienced mid-trimester pregnancy loss by comparing the outcomes between women who chose history-indicated cerclage and those who chose serial ultrasound assessment. Methods: We examined the medical records of women who delivered at our hospital between 2010 and 2018 and extracted cases with a history of mid-trimester pregnancy loss between 14 and 25 weeks' gestation. We compared the women with and without history-indicated cerclage. For women who choose expectant management, cervical length was assessed by transvaginal ultrasound every two weeks, and ultrasound-indicated cerclage was performed. The primary outcome was preterm birth before 28 or 34 weeks. Results: The study criteria were met by 63 women; among these, 28 had received history-indicated cerclage. The incidence of preterm birth at 28 and 34 weeks was similar between the two groups. However, among the 30 women who experienced painless cervical dilation at prior pregnancy loss, history-indicated cerclage showed significant low preterm birth rate compared with expectant management: 2/22 (9.1%) vs. 4/8 (50.0%) at <28 weeks (p = 0.029) and showed a lower preterm birth rate: 3/22 (13.6%) vs. 4/8 (50.0%) at <34 weeks (p = 0.06). Conclusions: History-indicated cerclage can be considered in women with a history of mid-trimester pregnancy loss who experience painless cervical dilation. |
| format | Article |
| id | doaj-art-693ab7fc5ca54f04a46eaa2236196b62 |
| institution | Kabale University |
| issn | 0390-6663 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj-art-693ab7fc5ca54f04a46eaa2236196b622025-01-25T07:14:26ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632025-01-015212633810.31083/CEOG26338S0390-6663(24)02527-2Efficacy of Prophylactic Cerclage in Women with a Single History of Mid-Trimester Pregnancy Loss with Painless Cervical Dilation: A Retrospective Cohort StudyAtsuko Tezuka0Hiroyuki Tsuda1Yumiko Ito2Tomoko Ando3Department of Obstetrics and Gynecology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, 453-8511 Nagoya, JapanDepartment of Obstetrics and Gynecology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, 453-8511 Nagoya, JapanDepartment of Obstetrics and Gynecology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, 453-8511 Nagoya, JapanDepartment of Obstetrics and Gynecology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, 453-8511 Nagoya, JapanBackground: Recently, serial ultrasound assessment of cervical length has been proposed as an alternative management of history-indicated cerclage. To investigate the efficacy of prophylactic cerclage among women who had previously experienced mid-trimester pregnancy loss by comparing the outcomes between women who chose history-indicated cerclage and those who chose serial ultrasound assessment. Methods: We examined the medical records of women who delivered at our hospital between 2010 and 2018 and extracted cases with a history of mid-trimester pregnancy loss between 14 and 25 weeks' gestation. We compared the women with and without history-indicated cerclage. For women who choose expectant management, cervical length was assessed by transvaginal ultrasound every two weeks, and ultrasound-indicated cerclage was performed. The primary outcome was preterm birth before 28 or 34 weeks. Results: The study criteria were met by 63 women; among these, 28 had received history-indicated cerclage. The incidence of preterm birth at 28 and 34 weeks was similar between the two groups. However, among the 30 women who experienced painless cervical dilation at prior pregnancy loss, history-indicated cerclage showed significant low preterm birth rate compared with expectant management: 2/22 (9.1%) vs. 4/8 (50.0%) at <28 weeks (p = 0.029) and showed a lower preterm birth rate: 3/22 (13.6%) vs. 4/8 (50.0%) at <34 weeks (p = 0.06). Conclusions: History-indicated cerclage can be considered in women with a history of mid-trimester pregnancy loss who experience painless cervical dilation.https://www.imrpress.com/journal/CEOG/52/1/10.31083/CEOG26338cerclagecervicalpremature birthuterine cervical incompetence |
| spellingShingle | Atsuko Tezuka Hiroyuki Tsuda Yumiko Ito Tomoko Ando Efficacy of Prophylactic Cerclage in Women with a Single History of Mid-Trimester Pregnancy Loss with Painless Cervical Dilation: A Retrospective Cohort Study Clinical and Experimental Obstetrics & Gynecology cerclage cervical premature birth uterine cervical incompetence |
| title | Efficacy of Prophylactic Cerclage in Women with a Single History of Mid-Trimester Pregnancy Loss with Painless Cervical Dilation: A Retrospective Cohort Study |
| title_full | Efficacy of Prophylactic Cerclage in Women with a Single History of Mid-Trimester Pregnancy Loss with Painless Cervical Dilation: A Retrospective Cohort Study |
| title_fullStr | Efficacy of Prophylactic Cerclage in Women with a Single History of Mid-Trimester Pregnancy Loss with Painless Cervical Dilation: A Retrospective Cohort Study |
| title_full_unstemmed | Efficacy of Prophylactic Cerclage in Women with a Single History of Mid-Trimester Pregnancy Loss with Painless Cervical Dilation: A Retrospective Cohort Study |
| title_short | Efficacy of Prophylactic Cerclage in Women with a Single History of Mid-Trimester Pregnancy Loss with Painless Cervical Dilation: A Retrospective Cohort Study |
| title_sort | efficacy of prophylactic cerclage in women with a single history of mid trimester pregnancy loss with painless cervical dilation a retrospective cohort study |
| topic | cerclage cervical premature birth uterine cervical incompetence |
| url | https://www.imrpress.com/journal/CEOG/52/1/10.31083/CEOG26338 |
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