Prophylactic Cervical Cerclage in Cases Following Cervical Conization at a Japanese Perinatal Center

Area of Science:

• Perinatal Medicine
• Reproductive Surgery
• Obstetrics

Background:

• Cervical conization increases the risk of preterm delivery.
• Prophylactic cervical cerclage is sometimes used to prevent preterm birth in high-risk pregnancies.

Purpose of the Study:

• To evaluate the effectiveness of prophylactic cervical cerclage in preventing preterm delivery in women with a history of cervical conization.
• To investigate factors associated with preterm delivery in this patient group.

Main Methods:

• Retrospective cohort study comparing obstetric outcomes.
• Inclusion of pregnant women with prior cervical conization managed between 2004 and 2023.
• Comparison of outcomes between women who received prophylactic cervical cerclage and those who did not.

Main Results:

• No significant difference in preterm delivery rates between cerclage and no-cerclage groups (15% vs. 31%, p=0.38).
• 100% prevalence of histological chorioamnionitis (CAM) in preterm deliveries following cerclage.
• Prophylactic cerclage did not prevent preterm delivery linked to CAM.

Conclusions:

• Prophylactic cervical cerclage may not be effective in preventing preterm delivery after cervical conization.
• Histological chorioamnionitis appears to be a significant factor in preterm delivery in this population.
• Further research is needed to explore alternative strategies for preventing preterm birth in women with a history of cervical conization.