Perinatal outcomes in patients undergoing repeat cerclage: A retrospective case series study

Author:

Ru Ping1,Ni Xiaotian1,Xu Wenyi1,Liu Yun1,Meng Lulu1,Yuan Wenjun2,Gu Zhuorong2,Shi Junyao3,Su Xiujuan4,Liu Ming1,Duan Tao15

Affiliation:

1. Department of Obstetrics, Shanghai East Hospital Tongji University School of Medicine Shanghai China

2. Department of Obstetrics and Gynecology, Shanghai Tongren Hospital Shanghai Jiaotong University School of Medicine Shanghai China

3. Shanghai Pudong Center for Women and Children's Health Shanghai China

4. Clinical Research Center, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine Tongji University Shanghai China

5. Department of Obstetrics, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine Tongji University Shanghai China

Abstract

AbstractObjectiveThis study aimed to describe the pregnancy outcomes of a case series of patients with probable cerclage failure who received repeat cerclage (RC) with potential indications.MethodsWe retrospectively collected a case series of 55 singleton pregnancies with RC from 2019 to 2022 in Shanghai, China. All included women provided written informed consent, and the study was approved by the ethics committees of the two hospitals. We compared pregnancy outcomes between pregnancies with RC for different indications.ResultsAmong the case series, nine patients underwent RC for the indication of protruding membranes below the previous suture loop (group A), and the other 46 patients for painless cervix dilation (group B). Gestational age at delivery was shorter in group B than in group A (30.7 vs 37.6 weeks,P = 0.009). Rates of preterm birth <32 weeks (63.0% vs 22.2%,P = 0.033) and < 37 weeks (76.1% vs 33.3%,P = 0.002) were significantly higher in group B than in group A. Of the 46 patients who underwent RC for painless cervical dilation, 28 had cervical dilation of 1 to 2 cm (group C) and the other 18 had cervical dilation of 3 to 6 cm (group D). The gestational age at delivery was shorter in group D than in group C (27.4 vs 31.5 weeks,P = 0.037). However, rates of preterm birth <32 or <37 weeks were similar between the groups.ConclusionRC may constitute a rescue strategy for patients with probable cerclage failure. Protrusion of membranes below the cerclage loop or cervical dilation <3 cm may be an indicator of better pregnancy outcome.

Funder

Shanghai Pudong New Area Health Commission

Publisher

Wiley

Subject

Obstetrics and Gynecology,General Medicine

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