Abstract
Purpose
To compare the pregnancy outcome of the modified transvaginal cerclage performed preconception and during pregnancy.
Methods
A retrospective trial was carried out in the Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital in Zhejiang, China. A total of 604 women with cervical incompetence underwent the cerclage, and the time of the operation was decided by the patients or depended on when the patient presented. Main outcome measures were the gestational age and the fetal outcome.
Results
After the cerclage, the mean gestational age at delivery and the term delivery rate were significantly higher in history-indicated conception cerclage compared to preconception cerclage (36.8 ± 3.7 vs 35.8 ± 4.7, p < 0.01; 76.1 vs 66.9%, p < 0.05). The mean gestational age at delivery and the term delivery rate were significantly higher in ultrasound-indicated compared to physical examination-indicated conception cerclage (35.0 ± 5.7 vs 31.0 ± 5.5, p < 0.01; 63.2 vs 23.3%, p < 0.001). The fetal survival rate had no difference in these two comparisons, respectively.
Conclusions
The modified transvaginal cervicoisthmic cerclage is a promising and safe technique to improve obstetric outcomes in women with cervical incompetence in different cerclage indications, and history-indicated conception cerclage appears to have better pregnancy outcome.
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Funding
This study was sponsored by The Key Research and Development Program of Zhejiang Province (2017C03022) and The National Natural Science Foundation of China (81401264).
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MW contributed to data collection, data analysis, manuscript writing. XJ and CY helped with data collection. TL was involved in data presentation, manuscript writing. DH helped with data analysis. SZ contributed to project management, operation performed.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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Wei, M., Jin, X., Li, T.C. et al. A comparison of pregnancy outcome of modified transvaginal cervicoisthmic cerclage performed prior to and during pregnancy. Arch Gynecol Obstet 297, 645–652 (2018). https://doi.org/10.1007/s00404-017-4636-x
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DOI: https://doi.org/10.1007/s00404-017-4636-x