King's College London

TY - JOUR

T1 - Cervical Cerclage for Preterm Birth Prevention in Twin Gestations with Short Cervix: A Case-Control Study.

AU - Houlihan, Christopher

AU - Poon, Chiu Yee Liona

AU - Ciarlo, Michele

AU - Kim, Eugene

AU - Guzman, Edwin

AU - Nicolaides, Kypros Herodotou

PY - 2016/3/16

Y1 - 2016/3/16

N2 - 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.

AB - 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.

U2 - 10.1002/uog.15918

DO - 10.1002/uog.15918

M3 - Article

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

SN - 0029-7844

ER -