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Abstract
Discussion Forum (0)
Adverse Pregnancy Outcomes of Cervical Cerclage According to the Indications

INTRODUCTION:
The objective of this study was to examine pregnancy outcomes of patients who underwent cervical cerclage according to cerclage indications.
METHODS:
This was a retrospective cohort study of patients with a singleton pregnancy who underwent cervical cerclage from 2014 to 2020 at a single academic institution. Patients were categorized according to cervical cerclage indications (history-indicated, ultrasound-indicated [cervical length 1–2.4 cm versus less than 1 cm], and physical exam indicated cerclage). Our primary outcome was spontaneous preterm delivery before 37 weeks of gestation. Outcomes were compared according to cervical cerclage indications. Multivariable logistic regression models were used to calculate adjusted odds ratios (aORs) and 95% CI, adjusting for a history of preterm delivery. Our IRB approved this analysis.
RESULTS:
Of 501 patients, 240 (47.9%), 115 (23.0%), 50 (10.0%), and 96 (19.2%) had a history-indicated, ultrasound-indicated (1–2.4 cm), ultrasound-indicated (<1 cm), and physical exam-indicated cerclage, respectively. Rates of preterm delivery were statistically different according to the indications. Compared to history-indicated cerclage, physical exam-indicated cerclage was associated with spontaneous preterm delivery (adjusted odds ratio [aOR] 3.97, 95% CI 2.27–6.97), preterm delivery (aOR 3.48, 95% CI 2.23–5.96), spontaneous preterm delivery less than 34 weeks (aOR 5.60, 95% CI 2.92–10.74), and neonatal demise or stillbirth (aOR 3.18, 95% CI 1.35–7.50). Compared to history-indicated cerclage, ultrasound-indicated cerclage (1–2.4 cm) was associated with preterm delivery (aOR 1.70, 95% CI 1.07–2.72) and neonatal intensive care unit (NICU) admission (aOR 1.81, 95% CI 1.11–2.96). Compared to history-indicated cerclage, ultrasound-indicated cerclage (<1 cm) was associated with spontaneous preterm delivery less than 34 weeks (aOR 2.46, 95% CI 1.02–5.94) and NICU admission (aOR 2.51, 95% CI 1.23–3.36).
CONCLUSION:
Compared to history-indicated cerclage, other cerclage indications were associated with increased odds of adverse pregnancy outcomes.

DOI: 10.1097/01.AOG.0000931020.06793.51
Adverse Pregnancy Outcomes of Cervical Cerclage According to the Indications

INTRODUCTION:
The objective of this study was to examine pregnancy outcomes of patients who underwent cervical cerclage according to cerclage indications.
METHODS:
This was a retrospective cohort study of patients with a singleton pregnancy who underwent cervical cerclage from 2014 to 2020 at a single academic institution. Patients were categorized according to cervical cerclage indications (history-indicated, ultrasound-indicated [cervical length 1–2.4 cm versus less than 1 cm], and physical exam indicated cerclage). Our primary outcome was spontaneous preterm delivery before 37 weeks of gestation. Outcomes were compared according to cervical cerclage indications. Multivariable logistic regression models were used to calculate adjusted odds ratios (aORs) and 95% CI, adjusting for a history of preterm delivery. Our IRB approved this analysis.
RESULTS:
Of 501 patients, 240 (47.9%), 115 (23.0%), 50 (10.0%), and 96 (19.2%) had a history-indicated, ultrasound-indicated (1–2.4 cm), ultrasound-indicated (<1 cm), and physical exam-indicated cerclage, respectively. Rates of preterm delivery were statistically different according to the indications. Compared to history-indicated cerclage, physical exam-indicated cerclage was associated with spontaneous preterm delivery (adjusted odds ratio [aOR] 3.97, 95% CI 2.27–6.97), preterm delivery (aOR 3.48, 95% CI 2.23–5.96), spontaneous preterm delivery less than 34 weeks (aOR 5.60, 95% CI 2.92–10.74), and neonatal demise or stillbirth (aOR 3.18, 95% CI 1.35–7.50). Compared to history-indicated cerclage, ultrasound-indicated cerclage (1–2.4 cm) was associated with preterm delivery (aOR 1.70, 95% CI 1.07–2.72) and neonatal intensive care unit (NICU) admission (aOR 1.81, 95% CI 1.11–2.96). Compared to history-indicated cerclage, ultrasound-indicated cerclage (<1 cm) was associated with spontaneous preterm delivery less than 34 weeks (aOR 2.46, 95% CI 1.02–5.94) and NICU admission (aOR 2.51, 95% CI 1.23–3.36).
CONCLUSION:
Compared to history-indicated cerclage, other cerclage indications were associated with increased odds of adverse pregnancy outcomes.

DOI: 10.1097/01.AOG.0000931020.06793.51
Adverse Pregnancy Outcomes of Cervical Cerclage According to the Indications.
Dr. Lea Nehme
Dr. Lea Nehme
ACOG ePoster. Nehme L. 05/21/2023; 376858; N-16
user
Dr. Lea Nehme
Abstract
Discussion Forum (0)
Adverse Pregnancy Outcomes of Cervical Cerclage According to the Indications

INTRODUCTION:
The objective of this study was to examine pregnancy outcomes of patients who underwent cervical cerclage according to cerclage indications.
METHODS:
This was a retrospective cohort study of patients with a singleton pregnancy who underwent cervical cerclage from 2014 to 2020 at a single academic institution. Patients were categorized according to cervical cerclage indications (history-indicated, ultrasound-indicated [cervical length 1–2.4 cm versus less than 1 cm], and physical exam indicated cerclage). Our primary outcome was spontaneous preterm delivery before 37 weeks of gestation. Outcomes were compared according to cervical cerclage indications. Multivariable logistic regression models were used to calculate adjusted odds ratios (aORs) and 95% CI, adjusting for a history of preterm delivery. Our IRB approved this analysis.
RESULTS:
Of 501 patients, 240 (47.9%), 115 (23.0%), 50 (10.0%), and 96 (19.2%) had a history-indicated, ultrasound-indicated (1–2.4 cm), ultrasound-indicated (<1 cm), and physical exam-indicated cerclage, respectively. Rates of preterm delivery were statistically different according to the indications. Compared to history-indicated cerclage, physical exam-indicated cerclage was associated with spontaneous preterm delivery (adjusted odds ratio [aOR] 3.97, 95% CI 2.27–6.97), preterm delivery (aOR 3.48, 95% CI 2.23–5.96), spontaneous preterm delivery less than 34 weeks (aOR 5.60, 95% CI 2.92–10.74), and neonatal demise or stillbirth (aOR 3.18, 95% CI 1.35–7.50). Compared to history-indicated cerclage, ultrasound-indicated cerclage (1–2.4 cm) was associated with preterm delivery (aOR 1.70, 95% CI 1.07–2.72) and neonatal intensive care unit (NICU) admission (aOR 1.81, 95% CI 1.11–2.96). Compared to history-indicated cerclage, ultrasound-indicated cerclage (<1 cm) was associated with spontaneous preterm delivery less than 34 weeks (aOR 2.46, 95% CI 1.02–5.94) and NICU admission (aOR 2.51, 95% CI 1.23–3.36).
CONCLUSION:
Compared to history-indicated cerclage, other cerclage indications were associated with increased odds of adverse pregnancy outcomes.

DOI: 10.1097/01.AOG.0000931020.06793.51
Adverse Pregnancy Outcomes of Cervical Cerclage According to the Indications

INTRODUCTION:
The objective of this study was to examine pregnancy outcomes of patients who underwent cervical cerclage according to cerclage indications.
METHODS:
This was a retrospective cohort study of patients with a singleton pregnancy who underwent cervical cerclage from 2014 to 2020 at a single academic institution. Patients were categorized according to cervical cerclage indications (history-indicated, ultrasound-indicated [cervical length 1–2.4 cm versus less than 1 cm], and physical exam indicated cerclage). Our primary outcome was spontaneous preterm delivery before 37 weeks of gestation. Outcomes were compared according to cervical cerclage indications. Multivariable logistic regression models were used to calculate adjusted odds ratios (aORs) and 95% CI, adjusting for a history of preterm delivery. Our IRB approved this analysis.
RESULTS:
Of 501 patients, 240 (47.9%), 115 (23.0%), 50 (10.0%), and 96 (19.2%) had a history-indicated, ultrasound-indicated (1–2.4 cm), ultrasound-indicated (<1 cm), and physical exam-indicated cerclage, respectively. Rates of preterm delivery were statistically different according to the indications. Compared to history-indicated cerclage, physical exam-indicated cerclage was associated with spontaneous preterm delivery (adjusted odds ratio [aOR] 3.97, 95% CI 2.27–6.97), preterm delivery (aOR 3.48, 95% CI 2.23–5.96), spontaneous preterm delivery less than 34 weeks (aOR 5.60, 95% CI 2.92–10.74), and neonatal demise or stillbirth (aOR 3.18, 95% CI 1.35–7.50). Compared to history-indicated cerclage, ultrasound-indicated cerclage (1–2.4 cm) was associated with preterm delivery (aOR 1.70, 95% CI 1.07–2.72) and neonatal intensive care unit (NICU) admission (aOR 1.81, 95% CI 1.11–2.96). Compared to history-indicated cerclage, ultrasound-indicated cerclage (<1 cm) was associated with spontaneous preterm delivery less than 34 weeks (aOR 2.46, 95% CI 1.02–5.94) and NICU admission (aOR 2.51, 95% CI 1.23–3.36).
CONCLUSION:
Compared to history-indicated cerclage, other cerclage indications were associated with increased odds of adverse pregnancy outcomes.

DOI: 10.1097/01.AOG.0000931020.06793.51

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With roots dating back to 1951, the American College of Obstetricians and Gynecologists is the premier professional membership organization for obstetrician–gynecologists. The College’s activities include producing practice guidelines for providers and educational materials for patients, providing practice management and career support, facilitating programs and initiatives aimed at improving women’s health, and advocating on behalf of members and patients. With more than 60,000 members spanning the entire career lifecycle, ACOG is composed of 12 Districts. These Districts are made up of 98 Sections. ACOG's Districts and Sections represent various regions, countries, territories, and states in North and South America. ACOG members, or Fellows, are board certified obstetrician–gynecologists whose professional activities are devoted to the practice of obstetrics and/or gynecology, who possess unrestricted licenses to practice medicine, and who have attained high ethical and professional standing.
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