Predictive score for early preterm birth in decisions about emergency cervical cerclage in singleton pregnancies

To develop a simple score for assessing the risk of early preterm delivery before 32 weeks in women with singleton pregnancies receiving emergency cervical cerclage.

Retrospective study.

French tertiary care center from 1994 to 2006.

A total of 134 pregnant women underwent emergency cervical cerclage procedure at 15-26 weeks. The analysis concerned 85 singleton pregnancies after exclusion of women with a dilated cervix without visible membranes, or presenting for revision of failed prophylactic cerclage, or who had either preterm premature rupture of membranes or clinical signs of chorioamnionitis.

Multivariate logistic regression methods with rounded coefficients were used to develop a score to predict early preterm delivery before 32 weeks.

Early preterm delivery before 32 weeks.

The score, ranging from 0 to 15 points, was based on the following four criteria independently associated with early preterm delivery: obstetric history; cervical dilatation; membranes bulging into the vagina; and infection. Each score value was associated with a predicted probability of early preterm birth.

The score and its associated early preterm probabilities may be a valuable tool to help physicians in advising women about the need for emergency cerclage.