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

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Cerclage position, cervical length and preterm delivery in women undergoing ultrasound indicated cervical cerclage : A retrospective cohort study. / Cook, Joanna R.; Chatfield, Susan; Chandiramani, Manju et al.

In: PL o S One , Vol. 12, No. 6, e0178072, 01.06.2017.

Research output: Contribution to journalArticlepeer-review

Harvard

Cook, JR, Chatfield, S, Chandiramani, M, Kindinger, L, Cacciatore, S, Sykes, L, Teoh, T, Shennan, A, Terzidou, V & Bennett, PR 2017, 'Cerclage position, cervical length and preterm delivery in women undergoing ultrasound indicated cervical cerclage: A retrospective cohort study', PL o S One , vol. 12, no. 6, e0178072. https://doi.org/10.1371/journal.pone.0178072

APA

Cook, J. R., Chatfield, S., Chandiramani, M., Kindinger, L., Cacciatore, S., Sykes, L., Teoh, T., Shennan, A., Terzidou, V., & Bennett, P. R. (2017). Cerclage position, cervical length and preterm delivery in women undergoing ultrasound indicated cervical cerclage: A retrospective cohort study. PL o S One , 12(6), [e0178072]. https://doi.org/10.1371/journal.pone.0178072

Vancouver

Cook JR, Chatfield S, Chandiramani M, Kindinger L, Cacciatore S, Sykes L et al. Cerclage position, cervical length and preterm delivery in women undergoing ultrasound indicated cervical cerclage: A retrospective cohort study. PL o S One . 2017 Jun 1;12(6). e0178072. https://doi.org/10.1371/journal.pone.0178072

Author

Cook, Joanna R. ; Chatfield, Susan ; Chandiramani, Manju et al. / Cerclage position, cervical length and preterm delivery in women undergoing ultrasound indicated cervical cerclage : A retrospective cohort study. In: PL o S One . 2017 ; Vol. 12, No. 6.

Bibtex Download

@article{45f7998a7f254fd69968c9365b8dbab3,
title = "Cerclage position, cervical length and preterm delivery in women undergoing ultrasound indicated cervical cerclage: A retrospective cohort study",
abstract = "Objective The objectives were to assess whether anatomical location of ultrasound (USS) indicated cervical cerclage and/or the degree of cervical shortening (cervical length; CL) prior to and following cerclage affects the risk of preterm birth (PTB). Method A retrospective cohort study of 179 women receiving cerclage for short cervix (25mm) was performed. Demographic data, CL before and after cerclage insertion, height of cerclage (distance from external os) and gestation at delivery were collected. Relative risk (RR) and odds ratio (OR) of preterm delivery were calculated according to the anatomical location of the cerclage within the cervix and the CL before and after cerclage as categorical and continuous variables. Partition tree analysis was used to identify the threshold cerclage height that best predicts PTB. Results 25% (n = 45) delivered <34 weeks and 36% (n = 65) delivered <37 weeks. Risk of PTB was greater with cerclage in the distal 10mm (RR2.37, 95% CI 1.45±3.87) or the distal half of a closed cervix (RR2.16, 95% CI 1.45±3.87). Increasing absolute cerclage height was associated with a reduction in PTB (OR 0.87, 95% CI 0.82±0.94). A cerclage height <14.5 mm best predicts PTB (70.8%). Increasing CL following cerclage was associated with a reduction in PTB (OR0.87, 95% CI 0.82±0.94). Conversely, the risk of PTB was increased where CL remained static or shortened further following cerclage (RR2.34, 95% CI 1.04± Conclusion The higher a cerclage was placed within a shortened cervix, the lower the subsequent odds of PTB. 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 PTB.",
author = "Cook, {Joanna R.} and Susan Chatfield and Manju Chandiramani and Lindsay Kindinger and Stefano Cacciatore and Lynne Sykes and Tiong Teoh and Andrew Shennan and Vasso Terzidou and Bennett, {Phillip R.}",
year = "2017",
month = jun,
day = "1",
doi = "10.1371/journal.pone.0178072",
language = "English",
volume = "12",
journal = "PL o S One ",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "6",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Cerclage position, cervical length and preterm delivery in women undergoing ultrasound indicated cervical cerclage

T2 - A retrospective cohort study

AU - Cook, Joanna R.

AU - Chatfield, Susan

AU - Chandiramani, Manju

AU - Kindinger, Lindsay

AU - Cacciatore, Stefano

AU - Sykes, Lynne

AU - Teoh, Tiong

AU - Shennan, Andrew

AU - Terzidou, Vasso

AU - Bennett, Phillip R.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Objective The objectives were to assess whether anatomical location of ultrasound (USS) indicated cervical cerclage and/or the degree of cervical shortening (cervical length; CL) prior to and following cerclage affects the risk of preterm birth (PTB). Method A retrospective cohort study of 179 women receiving cerclage for short cervix (25mm) was performed. Demographic data, CL before and after cerclage insertion, height of cerclage (distance from external os) and gestation at delivery were collected. Relative risk (RR) and odds ratio (OR) of preterm delivery were calculated according to the anatomical location of the cerclage within the cervix and the CL before and after cerclage as categorical and continuous variables. Partition tree analysis was used to identify the threshold cerclage height that best predicts PTB. Results 25% (n = 45) delivered <34 weeks and 36% (n = 65) delivered <37 weeks. Risk of PTB was greater with cerclage in the distal 10mm (RR2.37, 95% CI 1.45±3.87) or the distal half of a closed cervix (RR2.16, 95% CI 1.45±3.87). Increasing absolute cerclage height was associated with a reduction in PTB (OR 0.87, 95% CI 0.82±0.94). A cerclage height <14.5 mm best predicts PTB (70.8%). Increasing CL following cerclage was associated with a reduction in PTB (OR0.87, 95% CI 0.82±0.94). Conversely, the risk of PTB was increased where CL remained static or shortened further following cerclage (RR2.34, 95% CI 1.04± Conclusion The higher a cerclage was placed within a shortened cervix, the lower the subsequent odds of PTB. 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 PTB.

AB - Objective The objectives were to assess whether anatomical location of ultrasound (USS) indicated cervical cerclage and/or the degree of cervical shortening (cervical length; CL) prior to and following cerclage affects the risk of preterm birth (PTB). Method A retrospective cohort study of 179 women receiving cerclage for short cervix (25mm) was performed. Demographic data, CL before and after cerclage insertion, height of cerclage (distance from external os) and gestation at delivery were collected. Relative risk (RR) and odds ratio (OR) of preterm delivery were calculated according to the anatomical location of the cerclage within the cervix and the CL before and after cerclage as categorical and continuous variables. Partition tree analysis was used to identify the threshold cerclage height that best predicts PTB. Results 25% (n = 45) delivered <34 weeks and 36% (n = 65) delivered <37 weeks. Risk of PTB was greater with cerclage in the distal 10mm (RR2.37, 95% CI 1.45±3.87) or the distal half of a closed cervix (RR2.16, 95% CI 1.45±3.87). Increasing absolute cerclage height was associated with a reduction in PTB (OR 0.87, 95% CI 0.82±0.94). A cerclage height <14.5 mm best predicts PTB (70.8%). Increasing CL following cerclage was associated with a reduction in PTB (OR0.87, 95% CI 0.82±0.94). Conversely, the risk of PTB was increased where CL remained static or shortened further following cerclage (RR2.34, 95% CI 1.04± Conclusion The higher a cerclage was placed within a shortened cervix, the lower the subsequent odds of PTB. 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 PTB.

UR - http://www.scopus.com/inward/record.url?scp=85020003955&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0178072

DO - 10.1371/journal.pone.0178072

M3 - Article

AN - SCOPUS:85020003955

VL - 12

JO - PL o S One

JF - PL o S One

SN - 1932-6203

IS - 6

M1 - e0178072

ER -

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