Cerclage for Short Cervix on Ultrasonography: Meta-Analysis of Trials Using Individual Patient-Level Data

  title={Cerclage for Short Cervix on Ultrasonography: Meta-Analysis of Trials Using Individual Patient-Level Data},
  author={Vincenzo Berghella and Anthony O Odibo and Meekai S To and Orion A. Rust and Sietske M. Althuisius},
  journal={Obstetrics \& Gynecology},
Objective: Preterm birth is the main cause of perinatal morbidity and mortality. A short cervical length on transvaginal ultrasonography predicts preterm birth. Our aim was to estimate by meta-analysis of randomized trials whether cerclage prevents preterm birth in women with a short cervical length. Data Sources: MEDLINE, PubMed, EMBASE, and the Cochrane Library were searched with the terms “cerclage,” “cervical cerclage,” “short cervix,” “ultrasound,” and “randomized trial.” We included… 

Cerclage for Short Cervix on Ultrasonography in Women With Singleton Gestations and Previous Preterm Birth: A Meta-Analysis

In women with previous spontaneous preterm birth, singleton gestation, and cervical length less than 25 mm, cerclage significantly prevents pre term birth and composite perinatal mortality and morbidity.

Cervix on Ultrasound in Singleton Gestations without Prior Spontaneous Preterm Birth : a Systematic Review and Meta-analysis of Trials using individual patient-level data

In women with singleton gestation, without prior spontaneous PTB but with TVU CL <25mm in the second trimester, cerclage does not prevent preterm delivery or improve neonatal outcome and the quality of evidence was judged as low.

Does cervical cerclage decrease preterm birth in twin pregnancies with a short cervix?

Cerclage placement for cervical length ≤2.5 cm in twin gestations with mid-trimester short cervix did not decrease the rate of preterm birth at <35 weeks; however, cerclage placements for cervicallength was associated with a significantly decreased rate ofPreterm birth<35 weeks when compared to patients managed without cerclages.

Cerclage position, cervical length and preterm delivery in women undergoing ultrasound indicated cervical cerclage: A retrospective cohort study

Women whose cerclage is placed in the distal 10mm of closed cervix or whose cervix fails to elongate subsequently, should remain under close surveillance as they have the highest risk of preterm birth.

No. 257-Ultrasonographic Cervical Length Assessment in Predicting Preterm Birth in Singleton Pregnancies.

  • K. LimK. ButtJ. Crane
  • Medicine
    Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
  • 2018

Assessment of cervical length by transvaginal ultrasonography to predict preterm delivery in twin pregnancy

  • N. AsnafiZ. BasiratK. Hajian-TilakiS. Dadvar
  • Medicine
    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
  • 2013
Transvaginal sonographic measurement of cervical length is recommended for assessment of CL between 22–24 weeks for prediction of SPD in twin pregnancy to predict preterm birth in twin pregnant women.

Evaluation of cervical cerclage for sonographically incompetent cervix in at high risk patients.

Cervical sonography can be a valuable adjunct to clinical evaluation of patients with history of two or more recurrent midtrimester abortions/preterm deliveries with high success rate of cervical cerclage on properly selected patients with sonographic evidence of cervical changes.

Cerclage for women with twin pregnancies: a systematic review and metaanalysis.

SOGC Clinical Practice Guideline. Ultrasonographic cervical length assessment in predicting preterm birth in singleton pregnancies.

  • K. LimK. ButtJ. Crane
  • Medicine
    Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
  • 2011

The Value of Late Mid-Trimester Ultrasound Cervical Assessment after Cerclage for the Prediction of Preterm Birth

Transvaginal ultrasound for cervical assessment can be a helpful tool in the prediction of preterm birth after cerclage insertion and can guide the addition of interventions such, progesterone and antenatal corticosteroids for fetal lung maturation.



Prevention of Preterm Birth by Cervical Cerclage Compared With Expectant Management:: A Systematic Review

There is a trend toward cervical cerclage reducing preterm births before 34 weeks, and the use of cerclages is, however, associated with an increased risk of postpartum fever.

Cervical cerclage for prevention of preterm delivery in women with a short cervix: A randomized, controlled trial

In this trial, placing a cervical suture in women with a short cervix did not lower the risk of early preterm delivery in a substantial proportion of cases, but routinely measuring cervical length at 22 to 24 weeks gestation by transvaginal sonography does identify women who are at high risk of first-time delivery.

Does cervical cerclage prevent preterm delivery in patients with a short cervix?

Cervical cerclage in patients with a short cervix did not reduce the rate of spontaneous preterm delivery and increased the risk of preterm premature rupture of membranes.

Revisiting the short cervix detected by transvaginal ultrasound in the second trimester: why cerclage therapy may not help.

The sonographic findings of second trimester internal os dilation, membrane prolapse, and distal cervical shortening likely represent a common pathway of several pathophysiologic processes.