Does the rate of cervical shortening after cerclage predict preterm birth?*

  title={Does the rate of cervical shortening after cerclage predict preterm birth?*},
  author={Daphnie Drassinower and Joy S Vink and Noelia M. Zork and Cara Pessel and Kavita Vani and Sara G. Brubaker and Cande V. Ananth},
  journal={The Journal of Maternal-Fetal \& Neonatal Medicine},
  pages={2233 - 2239}
Abstract Objective: The objective of this study is to evaluate whether the rate of cervical shortening after cerclage can predict spontaneous preterm birth (SPTB). Methods: Women who had cervical length (CL) assessments after cerclage placement were identified. The rate of cervical shortening and its relationship with SPTB was established using a generalized linear regression model. Secondary outcomes included relationship between cervical shortening and risk of SPTB in those with a post… Expand
Prediction of preterm birth and adverse perinatal outcomes after cervical pessary placement in singleton pregnancies with short cervical length
  • M. Mendoza, N. Maiz, +4 authors E. Carreras
  • 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
  • 2019
The results help to better identify women in whom the pessary is more likely to fail, and can be predicted by measuring CL, A-UCA, CLCI, and ISA immediately after pessaries placement, being CL and A- UCA more accurate and easier to be measured. Expand
Predictors of cerclage failure in patients with singleton pregnancy undergoing prophylactic cervical cerclage
This is the first study showing that a history of previous uterine instrumentation is an independent predictor of cerclage failure, has significant clinical implications for women of childbearing age and when management of miscarriage/abortion is being considered. Expand
Cervical modifications after pessary placement in singleton pregnancies with maternal short cervical length: 2D and 3D ultrasound evaluation
Evaluated multiple cervical characteristics assessed by 2‐dimensional and 3‐dimensional ultrasound before and after placement of a cervical pessary to ascertain its mechanism of action. Expand
Controversies in the prevention of spontaneous preterm birth in asymptomatic women: an evidence summary and expert opinion
This review addresses six important clinical questions about preterm birth prevention as voted for by members of the UK Preterm Clinical Network. Expand


Rate of sonographic cervical shortening and the risk of spontaneous preterm birth.
Among women with a sonographically short cervix, the rate of change in CL is associated with SPTB, independent of fetal fibronectin test and other important risk factors for SPTB. Expand
Multicenter randomized trial of cerclage for preterm birth prevention in high-risk women with shortened midtrimester cervical length.
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 more than 35 weeks, unless cervical length was less than 15 mm. Expand
Change in Cervical Length After Cerclage as a Predictor of Preterm Delivery
The increase in cervical length after cerclage is not predictive of term delivery, but serial cervical length measurements in the late second or early third trimester predict preterm birth but could provide earlier warning in patients with a prophylactic cerclages than in patients in the urgent group. Expand
Cervical cerclage for prevention of preterm delivery in woman with short cervix:randomised controlled trial
This multicentre randomised controlled trial investigated whether, in women with a short cervix identified by routine transvaginal scanning at 22-24 weeks' gestation, the insertion of a Shirodkar suture reduces early preterm delivery. Expand
Is there value for serial ultrasonographic assessment of cervical lengths after a cerclage?
Although the overall cervical length by serial TVS after cerclage did not predict preterm birth, absent CLA is associated with preterm delivery, chorioamnionitis, and PPROM. Expand
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. Expand
Prediction of cervical cerclage outcome by endovaginal ultrasonography.
Endovaginal ultrasonographic assessment of the cervix in patients with cervical cerclage is a useful adjunct for predicting outcome and for counseling the patient. Expand
The rate of cervical change and the phenotype of spontaneous preterm birth.
Cervical shortening occurs at the same rate before spontaneous preterm birth, regardless of presentation, and is similar in women who presented with preterm labor and preterm ruptured membranes. Expand
Cerclage for prevention of preterm birth in women with a short cervix found on transvaginal ultrasound examination: a randomized trial.
Cerclage did not prevent preterm birth in women with a short cervix, and there was no difference in any obstetric or neonatal outcomes. Expand
Cervical length--time to report the rate of change?
  • J. Iams
  • Medicine
  • American journal of obstetrics and gynecology
  • 2014
These reports support changes in understanding “threatened preterm labor” less as a distinct event than as a process that can occur over weeks or months at variable rates of cervical change. Expand