TY - JOUR
T1 - Cerclage Location and Gestational Age at Delivery
AU - Estrada, Fatima
AU - Karakash, Scarlett
AU - Seetoe, Terry
AU - Weedon, Jeremy
AU - Minkoff, Howard
N1 - Publisher Copyright:
Copyright © 2019 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.
PY - 2019
Y1 - 2019
N2 - Objective Multiple authors have suggested cerclage position is a determinant of success. We assessed the interaction between cervical length (CL), cerclage height (cerH), proximal residual length (PRL), gestational age at delivery, and rate of delivery ≤ 34 weeks, in this study. Study Design Present study is a retrospective cohort study of all cerclages placed at Maimonides Medical Center from 2006 to 2016. Outcomes: gestational age at delivery and delivery before 34 weeks; predictors: PRL, cerH, CL; and indications for cerclage: history (Hx), physical exam (PE), and ultrasound (US) indicated cerclage. A general linear model was used to predict power-transformed age at delivery from cerH, CL, and indication for cerclage. Subanalyses by indication were conducted. Logistic regression was used for delivery ≤ 34 weeks. Results The cerH by indication did not reach statistical significance (p = 0.090). When stratified by indications, the effect of cerH on age at delivery was apparent for Hx (adjusted R 2 = 0.18, p < 0.001) and PE (adjusted R 2 = 0.43, p = 0.004) cerclages but not for US cerclages (adjusted R 2 = 0.08, p = 0.206). Logistic regression predicting delivery ≤ 34 weeks (n = 29) produced similar results. Conclusions For Hx and PE indicated cerclages, the location of the stitch may influence the timing of delivery. Specifically, the higher the cerclage, the more advanced the gestational age at delivery.
AB - Objective Multiple authors have suggested cerclage position is a determinant of success. We assessed the interaction between cervical length (CL), cerclage height (cerH), proximal residual length (PRL), gestational age at delivery, and rate of delivery ≤ 34 weeks, in this study. Study Design Present study is a retrospective cohort study of all cerclages placed at Maimonides Medical Center from 2006 to 2016. Outcomes: gestational age at delivery and delivery before 34 weeks; predictors: PRL, cerH, CL; and indications for cerclage: history (Hx), physical exam (PE), and ultrasound (US) indicated cerclage. A general linear model was used to predict power-transformed age at delivery from cerH, CL, and indication for cerclage. Subanalyses by indication were conducted. Logistic regression was used for delivery ≤ 34 weeks. Results The cerH by indication did not reach statistical significance (p = 0.090). When stratified by indications, the effect of cerH on age at delivery was apparent for Hx (adjusted R 2 = 0.18, p < 0.001) and PE (adjusted R 2 = 0.43, p = 0.004) cerclages but not for US cerclages (adjusted R 2 = 0.08, p = 0.206). Logistic regression predicting delivery ≤ 34 weeks (n = 29) produced similar results. Conclusions For Hx and PE indicated cerclages, the location of the stitch may influence the timing of delivery. Specifically, the higher the cerclage, the more advanced the gestational age at delivery.
KW - cerclage height
KW - cervical cerclage
KW - cervical length
KW - history indicated cerclage
KW - physical exam indicated cerclage
KW - preterm delivery
KW - proximal residual length
KW - ultrasound indicated cerclage
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U2 - 10.1055/s-0039-1688778
DO - 10.1055/s-0039-1688778
M3 - Article
AN - SCOPUS:85068418616
SN - 2157-6998
VL - 9
SP - E195-E199
JO - AJP Reports
JF - AJP Reports
IS - 2
ER -