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

Research output: Contribution to journalArticle

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
Publication statusE-pub ahead of print - 16 Mar 2016

Documents

  • uog15918

    uog15918.pdf, 0.99 MB, application/pdf

    1/04/2016

    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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