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Randomized Controlled Trial
. 2009 Oct;201(4):375.e1-8.
doi: 10.1016/j.ajog.2009.08.015.

Multicenter randomized trial of cerclage for preterm birth prevention in high-risk women with shortened midtrimester cervical length

John Owen  1 , Gary Hankins, Jay D Iams, Vincenzo Berghella, Jeanne S Sheffield, Annette Perez-Delboy, Robert S Egerman, Deborah A Wing, Mark Tomlinson, Richard Silver, Susan M Ramin, Edwin R Guzman, Michael Gordon, Helen Y How, Eric J Knudtson, Jeff M Szychowski, Suzanne Cliver, John C Hauth
Affiliations
Randomized Controlled Trial

Multicenter randomized trial of cerclage for preterm birth prevention in high-risk women with shortened midtrimester cervical length

John Owen et al. Am J Obstet Gynecol. 2009 Oct.

Erratum in

Abstract

Objective: The objective of the study was to assess cerclage to prevent recurrent preterm birth in women with short cervix.

Study design: Women with prior spontaneous preterm birth less than 34 weeks were screened for short cervix and randomly assigned to cerclage if cervical length was less than 25 mm.

Results: Of 1014 women screened, 302 were randomized; 42% of women not assigned and 32% of those assigned to cerclage delivered less than 35 weeks (P = .09). In planned analyses, birth less than 24 weeks (P = .03) and perinatal mortality (P = .046) were less frequent in the cerclage group. There was a significant interaction between cervical length and cerclage. Birth less than 35 weeks (P = .006) was reduced in the less than 15 mm stratum with a null effect in the 15-24 mm stratum.

Conclusion: In women with a prior spontaneous preterm birth less than 34 weeks and cervical length less than 25 mm, cerclage reduced previable birth and perinatal mortality but did not prevent birth less than 35 weeks, unless cervical length was less than 15 mm.

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References

    1. Owen J, Iams JD, Hauth JC. Vaginal sonography and cervical incompetence. Am J Obstet Gynecol. 2003;188:586–96. - PubMed
    1. Spong CY. Prediction and prevention of recurrent spontaneous preterm birth. Obstet Gynecol. 2007;110:405–415. - PubMed
    1. McDonald IA. Suture of the cervix for inevitable miscarriage. J Obstet Gynecol Br Empire. 1957;64:346–53. - PubMed
    1. Cromblehome WR, Minkooff HL, Delke I, Schwarz RH. Cervical cerclage: An aggressive approach to threatened or recurrent pregnancy wastage. Am J Obstet Gynecol. 1983;146:168–74. - PubMed
    1. Iams JD, Goldenberg RL, Meis PJ, Mercer BM, Moawad A, Das A, Thom E, McNellis D, Copper RL, Johnson F, Roberts JM for the National Institute of Child Health and Human Development Maternal Fetal Medicine Unit Network. The length of the cervix and the risk of spontaneous premature delivery. N Engl J Med. 1996;334:567–72. - PubMed

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