Repeat cerclage in singleton pregnant women whose cervixes dilated after initial ultrasound-indicated cerclage: A...

To compare the perinatal and neonatal outcomes of singleton pregnancies with and without repeat cerclage (RC) in women whose cervixes dilated after initial ultrasound-indicated cerclage (UIC).

This cohort study included women with singleton pregnancies who developed cervical dilation of 4 cm or less after initial UIC, and the patients were divided into two groups: a group managed with RC (labeled the RC group) and a control group. The results are presented as odds ratios (ORs) or as the mean difference (MD) and 95% confidence interval (CI).

A total of 42 women with singleton pregnancies who underwent (n = 22) or did not undergo (n = 20) RC were included. The demographic characteristics did not significantly differ between the groups. RC was associated with a significantly reduced incidence of spontaneous preterm birth (sPTB) at less than 34 weeks of pregnancy (22.73% vs. 65.00%; adjusted OR 0.14; 95% CI 0.032-0.61; P = 0.009). The average birth weight was significantly greater in the RC group than in the control group (2573.41 ± 973.31 vs. 1943.20 ± 929.49 g, P = 0.038). Compared with that in the control group, the NICU admission rate in the RC group was significantly reduced (15.00% vs. 50.00%; aOR 0.14, 95% CI 0.026-0.79, P = 0.026). RC appeared to prolong gestation, although the difference was not statistically significant (35.06 ± 4.85 vs. 32.17 ± 5.46 weeks, P = 0.077). The pregnancy duration after cervical dilation appeared to be greater in the RC group than in the control group (73.59 ± 27.07 vs. 57.35 ± 32.58 days, P = 0.086).

RC may reduce the risk of sPTB before 34 weeks of pregnancy, decrease the rate of admission to neonatal intensive care unit, and increase neonatal birth weight among women whose cervixes dilate after initial UIC during singleton pregnancies.