Cervical cerclage for singleton pregnant patients on vaginal progesterone with progressive cervical shortening

Enakpene, Christopher A.; DiGiovanni, Laura; Jones, Tiffany; Marshalla, Megan K.; Mastrogiannis, Dimitrios; Torre, Micaela Della

doi:10.1016/j.ajog.2018.06.020

Cited by 60 publications

(42 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There has been some retrospective data to suggest that women with extremely shortened CL ( 10 mm) and no history of SPTB may have improved outcomes with cerclage placement. 8,15 Our data suggest that routine cerclage prior to dilation in women with a CL 25 mm does not decrease the risk of SPTB. This supports the practice of performing serial CLs in women with a short cervix and potentially offering cerclage only if the cervix is dilated.…”

Section: Commentmentioning

confidence: 73%

Serial Cervical Length Evaluation in Low-Risk Women with Shortened Cervical Lengths in the Midtrimester: How Many Will Dilate Prior to 24 Weeks?

2019

View full text Add to dashboard Cite

Objective To determine what proportion of women with a short cervical length (CL) without a history of spontaneous preterm birth (SPTB) will ultimately be dilated at <24 weeks. Study Design This is a retrospective cohort study of women with singleton pregnancies with a short CL (≤25 mm) between 16 and 22 weeks' gestational age (GA). We excluded women with a history of SPTB. We examined the progression of women with short CL based on the CL measurement and GA at diagnosis. The primary outcome was cervical dilation or spontaneous delivery <24 weeks. Results A total of 163 women were included, of whom 27 (16.6%) were ultimately dilated and 4 (2.5%) had pregnancy loss by 24 weeks. The median GA at diagnosis of short CL was 195/7 (range: 15–22) weeks. Women with a CL <15 mm were more likely to have cervical dilation or loss prior to 24 weeks than women whose CL was 15 to 25 mm (42.5 vs. 11.9%, <0.001, adjusted odds ratio: 3.72, 95% confidence interval: 1.52–9.09). GA at diagnosis was not associated with risk of progression. Conclusion In women with a short CL without a history of SPTB, the risk of dilation or pregnancy loss <24 weeks is significant, approaching 50% for women with a CL <15 mm.

show abstract

Section: Commentmentioning

confidence: 73%

Serial Cervical Length Evaluation in Low-Risk Women with Shortened Cervical Lengths in the Midtrimester: How Many Will Dilate Prior to 24 Weeks?

2019

View full text Add to dashboard Cite

show abstract

“…Una revisión sistemática demostró que cuanto más corta es la LC, mayor es el riesgo de parto pretérmino y un valor de corte de menor de 25 milímetros es el de mayor utilidad 20 . Este valor de corte también se ha utilizado en otros estudios 21 . Sin embargo, la determinación de un cuello uterino corto en el tercer trimestre también está asociado a parto pretérmino 22 .…”

Section: Discussionunclassified

Longitud cervical o puntaje de bishop en la predicción de parto pretérmino inminente en pacientes sintomáticas.

lReyna-Villasmi

Mejia-Montilla

Reyna-Villasmil

et al. 2019

Rev. chil. obstet. ginecol.

View full text Add to dashboard Cite

Artículos de ínvestigaciónLongitud cervical o puntaje de bishop en la predicción de parto pretérmino inminente en pacientes sintomáticas.Cervical length or bishop score in prediction of imminent preterm delivery in symptomatic patients. RESUMEN OBJETIVO: Comparar la longitud cervical con el puntaje de Bishop en la predicción de parto pretérmino inminente en pacientes sintomáticas. MÉTODOS: Se seleccionaron mujeres con embarazos simples de 24 -35 semanas, con amenaza de parto pretérmino y membranas integras. Antes del inicio de cualquier tratamiento, todas fueron sometidas a examen digital del cuello uterino y determinación ecográfica transvaginal de la longitud cervical. La principal variable de estudio fue la frecuencia de parto inminente (en los 7 días siguientes a la evaluación). Se evaluaron las características generales, puntaje de Bishop y valores de la longitud cervical RESULTADOS: Fueron seleccionadas 481 mujeres, 119 participantes presentaron parto pretérmino inminente (grupo A) y 362 pacientes presentaron partos más allá de los 7 días (grupo B). El intervalo entre la evaluación y el parto fue de 4,3 +/-1,6 días en el grupo A y 56,3 +/-27,2 días en el grupo B (p < 0,0001). Las pacientes del grupo A tenían valores más bajos de longitud cervical comparado con las pacientes del grupo B (p < 0,0001). Este grupo también presentó valores más elevados de puntaje de Bishop (p < 0,0001). La longitud cervical tenía un área bajo la curva mayor para la predicción (0,972, intervalo de confianza 95%, 0,772 -1,000) comparado con el puntaje de Bisho (0,825, intervalo de confianza 95%, 0,783 -0,870; p = 0,0137). CONCLUSIÓN: La longitud cervical es más útil en la predicción de parto pretérmino inminente en pacientes sintomáticas comparado con el puntaje de Bishop. PALABRAS CLAVE:Longitud cervical; Puntaje de Bishop; Predicción; Parto pretérmino; amenaza de parto pretérmino.. REV CHIL OBSTET GINECOL 2019; 84(5): 362 -371 363 ABSTRACT OBJECTIVE: To compare the cervical length with Bishop score in prediction of imminent preterm delivery in symptomatic patients. METHODS:Women with single pregnancies of 24-35 weeks were selected, with the diagnosis of threatened preterm labor and intact membranes. Before the start of any treatment, all were submitted to the cervical digital examination and transvaginal ultrasound determination of cervical length. The main variable of the study was the frequency of imminent delivery (in the 7 days following evaluation). General characteristics, Bishop score, and cervical length values were evaluated. RESULTS: A total of 481 women were selected, 119 patients presented imminent delivery (group A) and 362 patients delivered after 7 days (group B). the interval between evaluation and delivery was 4.3 +/-1.6 days in group A and 56.3 +/-27.2 days in group B (p <0.0001). Patients in group A had lower values of cervical length compared with patients in group B (p <0.0001). This group also presented higher values of Bishop score (p <0.0001). Cervical length had a mayor area under for prediction (0.972, ...

show abstract

“…Recent studies have suggested that cervical cerclage in this group of women may prolong pregnancy and decrease preterm births. 2,3…”

Section: Objectivementioning

confidence: 99%

“…Cesarean delivery is associated with the persistent use of opioid pain relievers (OPRs), although whether this relates to the procedure or subsequent OPR prescribing is unclear. 1,2 We examined OPR prescribing and persistent OPR use among women undergoing cesarean and vaginal delivery.…”

Section: Objectivementioning

confidence: 99%

A stepwise approach for the management of short cervix: time to evolve beyond progesterone treatment in the presence of progressive cervical shortening

Daskalakis

Loutradis

Antsaklis

et al. 2019

American Journal of Obstetrics and Gynecology

View full text Add to dashboard Cite

Cervical cerclage for singleton pregnant patients on vaginal progesterone with progressive cervical shortening

Cited by 60 publications

References 32 publications

Serial Cervical Length Evaluation in Low-Risk Women with Shortened Cervical Lengths in the Midtrimester: How Many Will Dilate Prior to 24 Weeks?

Serial Cervical Length Evaluation in Low-Risk Women with Shortened Cervical Lengths in the Midtrimester: How Many Will Dilate Prior to 24 Weeks?

Longitud cervical o puntaje de bishop en la predicción de parto pretérmino inminente en pacientes sintomáticas.

A stepwise approach for the management of short cervix: time to evolve beyond progesterone treatment in the presence of progressive cervical shortening

Contact Info

Product

Resources

About