Abstract
Objective
Treatment modalities to reduce the incidence of preterm birth are currently limited.
Cerclage, is a common and established intervention in most obstetrics units worldwide,
however, many questions regarding its efficacy, with respect to pregnancy outcomes
remain unanswered. This study aims to investigate whether an antenatal placed cerclage
affects the subsequent mode of delivery in women at high risk of preterm birth who
labour.
Study design
A retrospective case controlled study was performed at St Thomas’s Hospital London.
Women who had undergone cervical cerclage were identified using a pre-existing database
(n = 152). Cases were excluded where a C-section had been performed prior to labour (n = 26), datasets were incomplete (n = 5) or a rescue cerclage was performed (n = 2). Remaining cases were categorised into those who had: history indicated (n = 68) or ultrasound indicated (n = 51) cerclage. Control cases were obtained from the same database who also laboured
but had not undergone cerclage, matched according to gestational age at delivery and
parity (n = 114). Demographic details and outcome data were recorded. Groups were compared using
Chi Squared analysis for discrete variables and t-test for continuous variables using IBM SPSS Statistics version 22.
Results
There was no statistical difference in the emergency C-section rate between history
indicated and ultrasound indicated cerclage, or between patients who received cerclage
and those who had not (p = 0.592). The emergency C-section rate for each group was: history indicated, 25%, ultrasound
indicated 18% and no cerclage 18%.
Conclusions
Women at risk of preterm birth have high rates of emergency C-section despite the
fact that the majority were multiparous. However, they can be reassured that cervical
cerclage does not increase this risk.
Keywords
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References
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Article info
Publication history
Published online: November 26, 2016
Accepted:
November 22,
2016
Received in revised form:
November 21,
2016
Received:
October 20,
2016
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.
