Effectiveness of elective cervical cerclage according to obstetric history - 20/03/17
, P. Marzouk a, J. Deu a, J.-F. Oury b, O. Sibony bBienvenue sur EM-consulte, la référence des professionnels de santé.
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Summary |
Objective |
To assess the effectiveness of elective history-indicated cervical cerclage according to obstetrical history.
Study design |
We analyzed pregnancy outcome of a retrospective cohort of women who have had history-indicated McDonald's cerclage. Principal outcome was gestational age (GA) at delivery.
Result |
Between January 2003 and December 2013, 205 women were included. We analyzed population in two risk groups: 1- Low-risk (≤2 prior preterm birth (PTB)/second trimester loss (STL), or prior success of cerclage), 2- High risk (≥3 prior PTB/STL, or prior failure of cerclage). In the high-risk group, there was a higher frequency of deliveries before 37 weeks (47.5% vs. 24.5%, P=0.001, OR=2.79, 95% CI [1.49–5.23]). Fifty percent of women (n=6/12) delivered before 37 weeks in case of three or more prior PTB/STL, and 51% (n=24/47) in case of prior failure of cervical cerclage.
Conclusion |
Elective cervical cerclage may be indicated for women with≤2 prior PTB/STL, or prior successful cerclage. For women with≥3 prior PTB/STL, trachelorraphy or cervico-isthmic cerclage could be possible alternatives to cervical cerclage.
Le texte complet de cet article est disponible en PDF.Keywords : Cervical cerclage, Preterm birth, Second trimester loss, Cervical insufficiency, Trachelorraphy
Plan
Vol 46 - N° 1
P. 53-59 - janvier 2017 Retour au numéro
Article précédent
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