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To do or not to do emergency cervical cerclage (a rescue stitch) at 24–28 weeks gestation in addition to progesterone for patients coming early in labor? A prospective randomized trial for efficacy and safety

  • Maternal-Fetal Medicine
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Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

An Editorial Expression of Concern to this article was published on 17 February 2023

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Abstract

Purpose

To measure the outcome of emergency cervical cerclage (ECC) combined with progesterone vs. progesterone alone in pregnancy prolongation for preterm labor at 24–28 weeks.

Methods

One hundred patients in early labor were allocated randomly into two equal groups. Group A were treated by ECC and progesterone, and group B were on the same progesterone dose only treatment.

Results

No significant differences were observed in both groups as regard demographic data, fetal gestational age or cervical state on admission. However, a significant pregnancy prolongation was observed in group A (28.44 ± 12.73 days vs. 9.96 ± 3.27 in group B, p < 0.001) with subsequent increase in fetal gestational age (32.04 ± 3.2 vs. 27.86 ± 3.213, p < 0.001), heavier weight, higher Apgar score at 1 and 5 min, and lower rate of cesarean delivery (1033.1 ± 170.83 vs. 715.1 ± 138.73, p < 0.001) (2.68 ± 1.132 vs. 2.14 ± 0.93, p < 0.001), (5.48 ± 2.6 vs. 2.38 ± 1.59, p = 0.01) and (16 vs. 62 %, p = 0.01), respectively. Also neonatal outcomes in terms of early neonatal deaths were lower in this group (18 vs. 46 %, p = 0.049).

Conclusions

ECC is effective in pregnancy prolongation when judiciously used in combination with progesterone compared to progesterone alone.

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Acknowledgments

The authors would like to thank their colleagues in the Obstetrics and Gynecology department who offer the maximum care to the patients during their hospital stay.

Conflict of interest

The authors report no conflicts of interest.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Mansoura College of Medicine, Mansoura University, Mansoura, Egypt

    Ahmed Ragab & Yasser Mesbah

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  1. Ahmed Ragab
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  2. Yasser Mesbah
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Correspondence to Ahmed Ragab.

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Ragab, A., Mesbah, Y. To do or not to do emergency cervical cerclage (a rescue stitch) at 24–28 weeks gestation in addition to progesterone for patients coming early in labor? A prospective randomized trial for efficacy and safety. Arch Gynecol Obstet 292, 1255–1260 (2015). https://doi.org/10.1007/s00404-015-3772-4

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  • DOI: https://doi.org/10.1007/s00404-015-3772-4

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