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Cervical Cerclage for Preterm Birth Prevention in Twin Gestations with Short Cervix: A Case-Control Study.

Research output: Contribution to journalArticlepeer-review

Christopher Houlihan, Chiu Yee Liona Poon, Michele Ciarlo, Eugene Kim, Edwin Guzman, Kypros Herodotou Nicolaides

Original languageEnglish
JournalObstetrics and Gynecology
Early online date16 Mar 2016
DOIs
Accepted/In press9 Mar 2016
E-pub ahead of print16 Mar 2016

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  • uog15918

    uog15918.pdf, 0.99 MB, application/pdf

    Uploaded date:01 Apr 2016

    Version:Accepted author manuscript

King's Authors

Abstract

Objective: To determine if cervical cerclage reduces the rate of spontaneous early preterm birth in cases of ultrasound detected short cervix in dichorionic/diamniotic (DC-DA) twins. Study Design: This was a case-control study. The cases were 40 consecutive DC-DA twins at Saint Peter’s University Hospital from November 2006 through May 2012 where cervical cerclage was performed for cervical length of 1-24 mm at 16-24 weeks’ gestation. The cases were matched with 40 controls with no cerclage for cervical length and gestational age at cervical assessment, maternal age, body mass index, racial origin, cigarette smoking, in-vitro fertilization, parity and prior preterm birth. The primary outcome measure was spontaneous delivery at <32 weeks. Results: In the cases, compared to controls, spontaneous delivery at <32 weeks was less frequent (20.0% vs. 50.0%; relative risk, 0.40; 95% confidence interval [CI], 0.20 to 0.80). Conclusion: In DC-DA twins with a short cervix, treatment with cervical cerclage may reduce the rate of early preterm birth. The findings recommend an adequate RCT on cerclage in twins with a short cervix.

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