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Related Experiment Videos

Does cerclage location influence perinatal outcome?

Orion A Rust1, Robert O Atlas, Joseph Meyn

  • 1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Lehigh Valley Hospital and Health Network, CC & I-78, PO Box 689, Allentown, PA 18105-1556, USA. Orion.Rust@LVH.com

American Journal of Obstetrics and Gynecology
|January 8, 2004
PubMed
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Cerclage placement closer to the internal os did not improve pregnancy duration. The location of cervical cerclage does not correlate with gestational age at birth in women with ultrasound-indicated cerclage.

Area of Science:

  • Maternal-fetal medicine
  • Obstetrics
  • Perinatology

Background:

  • Ultrasound-indicated cervical cerclage is used to prevent preterm birth in women with a short cervix.
  • The optimal location of the cerclage suture within the cervix is not well-defined.
  • Previous studies have not established a clear relationship between cerclage position and perinatal outcomes.

Purpose of the Study:

  • To measure the location of cervical cerclage within the cervix.
  • To determine if cerclage placement closer to the internal os is associated with improved perinatal outcomes.
  • To assess the relationship between cerclage position and gestational age at birth.

Main Methods:

  • Analysis of data from a randomized trial comparing cervical cerclage to no cerclage.

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  • Inclusion criteria: women with short cervix (<25 mm) or funneling between 16-24 weeks gestation.
  • Measurements included distance from external os to cerclage (A) and total cervical length (B), calculating the A/B ratio. Gestational age at birth was the primary outcome.

    • Main Results:

    • 74 women received a McDonald cerclage suture.
    • The mean cerclage to cervical length ratio (A/B) was 0.5 ± 0.1.
    • Linear regression analysis showed no correlation between cerclage location (A or A/B ratio) and gestational age at birth (P=.8 and P=.6, respectively).

    Conclusions:

    • The length of the cervix below the cerclage suture is not related to pregnancy duration.
    • Cerclage placement, when indicated by ultrasound for cervical effacement, does not appear to influence gestational age at birth based on its specific location.
    • Further research may be needed to identify other factors influencing outcomes in cerclage patients.