Does cervical cerclage prevent preterm delivery in patients with a short cervix?

Am J Obstet Gynecol. 2001 Jun;184(7):1325-9; discussion 1329-31. doi: 10.1067/mob.2001.115119.

Abstract

Objective: Our purpose was to determine whether cerclage placement in women with a short cervix on transvaginal ultrasonography reduces the rate of preterm delivery.

Study design: A retrospective cohort study identified patients with an ultrasonographic short cervix (cervical length < or =15 mm) between 14 and 24 weeks' gestation. Cerclage placement was performed at the discretion of the attending physician. Clinical characteristics and outcome with and without cerclage were compared.

Results: Seventy patients met inclusion criteria; 25 (36%) underwent cerclage placement. Patients managed with cerclage had a lower gestational age at diagnosis (19.6 weeks vs 21.3 weeks, P <.01) but had a similar median cervical length, presence of funneling, and a history of cervical surgery, in comparison with those managed without cerclage. The rate of spontaneous preterm delivery was not different between groups. Patients with cerclage had a higher rate of preterm premature rupture of membranes than those without cerclage (65.2% vs 36.4%, P <.05).

Conclusion: Cervical cerclage in patients with a short cervix did not reduce the rate of spontaneous preterm delivery and increased the risk of preterm premature rupture of membranes.

MeSH terms

  • Adolescent
  • Adult
  • Cervix Uteri / diagnostic imaging*
  • Cervix Uteri / surgery*
  • Cohort Studies
  • Female
  • Fetal Membranes, Premature Rupture / etiology
  • Humans
  • Middle Aged
  • Obstetric Labor, Premature / prevention & control*
  • Pregnancy
  • Retrospective Studies
  • Risk Factors
  • Suture Techniques* / adverse effects
  • Treatment Failure
  • Ultrasonography