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. 2022 Apr 4:9:846755.
doi: 10.3389/fmed.2022.846755. eCollection 2022.

Correlation Between Clinical Factors and Pregnancy Outcome Following Repeat Cerclage: A Retrospective Analysis of a Chinese Population

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Correlation Between Clinical Factors and Pregnancy Outcome Following Repeat Cerclage: A Retrospective Analysis of a Chinese Population

Benshuo Cai et al. Front Med (Lausanne). .

Abstract

Background: The role of repeat cerclage (RC) among patients with prolapsed membranes remains controversial. We aimed to investigate the effectiveness of RC and assess the correlation between clinical factors and pregnancy outcome following RC.

Methods: The clinical data of patients who underwent RC for prolapsed membranes after prior cerclage were retrospectively investigated. The clinical characteristics of patients were compared between singleton and twin pregnancies. The clinical characteristics of singleton pregnancies were compared between the gestational age (GA) at delivery <28 weeks' and ≥28 weeks' groups. Receiver operating characteristic (ROC) curve analysis was performed to determine predictive factors. Singleton patients were divided into two groups according to GA at RC as follows: GA <22.3 weeks and GA ≥22.3 weeks. Pregnancy outcomes were compared between groups.

Results: The mean GA at delivery of singleton pregnancies was significantly higher than that of twin pregnancies. The mean latency between RC and delivery of singleton pregnancies was significantly longer than their twin counterparts. There were significant differences in the pregnancy outcomes between the GA <22.3 weeks group and GA ≥22.3 weeks group. Kaplan-Meier survival curves showed a lower incidence of neonatal death in the GA ≥22.3 weeks group compared with that in the GA <22.3 weeks group.

Conclusions: RC may be an effective method to prolong the duration of pregnancy among patients with singleton pregnancy. However, the selection of RC for patients with twin pregnancies remains controversial. GA at RC appears to be fair for predicting pregnancy outcomes following RC.

Keywords: gestational age; pregnancy outcome; prolapsed membranes; repeat cerclage; retrospective analysis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Receiver operater characteristic (ROC) curve of gestational age (GA) at repeat cerclage (RC) predicting delivery ≥28 weeks of gestation. The area under the curve (AUC) is 0.746. GA ≥22.3 weeks at RC had a sensitivity of 100% and specificity of 50%.
Figure 2
Figure 2
Kaplan–Meier survival curve for neonatal death with gestational age (GA) at repeat cerclage (RC) ≥22.3 weeks and <22.3 weeks.

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References

    1. Yip SK, Fung HY, Fung TY. Emergency cervical cerclage: a study between duration of cerclage in situ with gestation at cerclage, herniation of forewater, and cervical dilatation at presentation. Eur J Obstet Gynecol Reprod Biol. (1998) 78:63–7. 10.1016/S0301-2115(98)00023-2 - DOI - PubMed
    1. Lipitz S, Libshitz A, Oelsner G, Kokia E, Goldenberg M, Mashiach S, et al. . Outcome of second-trimester, emergency cervical cerclage in patients with no history of cervical incompetence. Am J Perinatol. (1996) 13:419–22. 10.1055/s-2007-994381 - DOI - PubMed
    1. Hatakeyama Y, Miura H, Sato A, Onodera Y, Sato N, Shimizu D, et al. . Neutrophil elastase in amniotic fluid as a predictor of preterm birth after emergent cervical cerclage. Acta Obstet Gynecol Scand. (2016) 95:1136–42. 10.1111/aogs.12928 - DOI - PMC - PubMed
    1. Steenhaut P, Hubinont C, Bernard P, Debieve F. Retrospective comparison of perinatal outcomes following emergency cervical cerclage with or without prolapsed membranes. Int J Gynaecol Obstet. (2017) 137:260–4. 10.1002/ijgo.12144 - DOI - PubMed
    1. Kanbayashi S, Sato Y, Taga A, Satake Y, Emoto I, Maruyama S, et al. . Positive vaginal culture at rescue cerclage predicts subsequent preterm delivery. J Matern Fetal Neonatal Med. (2018) 31:1161–5. 10.1080/14767058.2017.1311313 - DOI - PubMed