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Effect of Cervical Cerclage on the Risk of Recurrent Preterm Birth after a Twin Spontaneous Preterm Birth

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Affiliated Author(s)
배진곤
Alternative Author(s)
Bae, Jin Gon
Journal Title
Journal of Korean Medical Science
ISSN
1598-6357
Issued Date
2020
Keyword
TwinsPremature BirthPreterm Premature Rupture of the MembranesUterine Cervical IncompetenceCervical Cerclage
Abstract
Background:
This study aimed to evaluate the effect of cervical cerclage on the recurrence risk for preterm birth in singleton pregnant women after a twin spontaneous preterm birth (sPTB).

Methods:
This multicenter retrospective cohort study included women who had a singleton pregnancy from January 2009 to December 2018 at 10 referral hospitals and a twin sPTB before the current pregnancy. We compared the cervical lengths during pregnancy and pregnancy outcomes, according to the placement of prophylactic or emergency cerclage. We evaluated the independent risk factors for sPTB (< 37 weeks of gestation) in a subsequent singleton pregnancy.

Results:
For the index singleton pregnancy, preterm birth occurred in seven (11.1%) of 63 women. There was no significant difference in the cervical lengths during pregnancy in women with and without cerclage. In a multivariate logistic regression analysis, the placement of emergency cerclage was an independent risk factor for subsequent singleton preterm birth (odds ratio [OR], 93.188; 95% confidence interval [CI], 1.633–5,316.628; P = 0.027); however, the placement of prophylactic cerclage (OR, 19.264; 95% CI, 0.915–405.786; P = 0.057) was not a factor. None of the women who received prophylactic cerclage delivered before 35 weeks' gestation in the index singleton pregnancy.

Conclusion:
Cerclage did not lower the risk of preterm birth in a subsequent singleton pregnancy after a twin sPTB. However, emergency cerclage was an independent risk factor for preterm birth and there was no preterm birth before 35 weeks' gestation in the prophylactic cerclage group. Therefore, close monitoring of the cervical length and prophylactic cerclage might be considered in women who have experienced a twin sPTB at extreme gestation.
Alternative Title
Effect of Cervical Cerclage on the Risk of Recurrent Preterm Birth after a Twin Spontaneous Preterm Birth
Department
Dept. of Obstetrics & Gynecology (산부인과학)
Publisher
School of Medicine (의과대학)
Citation
Shinyoung Kim et al. (2020). Effect of Cervical Cerclage on the Risk of Recurrent Preterm Birth after a Twin Spontaneous Preterm Birth. Journal of Korean Medical Science, 35(11), 1–10. doi: 10.3346/jkms.2020.35.e66
Type
Article
ISSN
1598-6357
DOI
10.3346/jkms.2020.35.e66
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42681
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Obstetrics & Gynecology (산부인과학)
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