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Cerclage for the prevention of preterm birth in high risk women receiving intramuscular 17-α-hydroxyprogesterone caproate
| Content Provider | Scilit |
|---|---|
| Author | Szychowski, Jeff M. Berghella, Vincenzo Owen, John Hankins, Gary Iams, Jay D. Sheffield, Jeanne S. Perez-Delboy, Annette Wing, Deborah A. Guzman, Edwin R. |
| Copyright Year | 2012 |
| Description | Journal: The Journal of Maternal-Fetal & Neonatal Medicine Objective: To assess cerclage benefit in women with short cervix also receiving 17-α-hydroxyprogesterone caproate (17P) to prevent recurrent preterm birth (PTB). Methods: Secondary analysis of a multicenter trial of ultrasound-indicated cerclage for shortened cervical length (CL). Women with prior spontaneous PTB at 16–33 6/7 weeks, singleton gestation and CL < 25 mm between 16 and 22 6/7 weeks were counseled on use of 17P and randomized to cerclage or no cerclage. Outcomes of women who received 17P were analyzed by randomization group. Primary outcome was PTB < 35 weeks. Results: 99 women received 17P: 47 cerclage; 52 no cerclage. Rates of PTB < 35 weeks were similar, 30% for cerclage and 38% for no cerclage (aOR 0.64 (0.27–1.52)). In women with CL < 15 mm, PTB < 35 weeks was reduced for the cerclage group (17% vs. 75%, p = 0.02). However, this difference was nullified after controlling for total progesterone doses received (p = 0.40). Conclusions: Cerclage was shown not to offer additional benefit for the prevention of recurrent PTB in women with short CL < 25 mm receiving 17P, but the sample size is insufficient for a definite conclusion given the 36% nonsignificant decrease in the odds of PTB < 35 weeks. Cerclage may further offer substantial benefit to women with very short CL < 15 mm and further study is needed. |
| Related Links | http://europepmc.org/articles/pmc3991237?pdf=render https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3991237/pdf https://www.tandfonline.com/doi/pdf/10.3109/14767058.2012.717128 |
| Ending Page | 2689 |
| Page Count | 4 |
| Starting Page | 2686 |
| ISSN | 14767058 |
| e-ISSN | 14764954 |
| DOI | 10.3109/14767058.2012.717128 |
| Journal | The Journal of Maternal-Fetal & Neonatal Medicine |
| Issue Number | 12 |
| Volume Number | 25 |
| Language | English |
| Publisher | Informa UK Limited |
| Publisher Date | 2012-08-22 |
| Access Restriction | Open |
| Subject Keyword | Journal: The Journal of Maternal-Fetal & Neonatal Medicine Obstetrics and Gynecology Progesterone Preterm Birth Short Cervical Length |
| Content Type | Text |
| Subject | Pediatrics, Perinatology and Child Health Obstetrics and Gynecology |
