ABSTRACT
We sought to estimate if there is an association between cerclage and cesarean delivery.
We performed a retrospective cohort study of women with high-risk factors for preterm
birth. Those with a cerclage were compared with those without. Outcomes included overall
incidence of cesarean delivery and incidence of cesarean delivery secondary to labor
arrest. We identified 724 women at high risk for preterm birth; 232 (32%) women had
cerclage placement, and 492 (68%) did not. There was no significant difference in
the overall incidence of cesarean delivery between the two groups (odds ratio 1.15;
95% confidence interval 0.81 to 1.63). When comparison was limited to women who underwent
a cesarean section secondary to labor arrest, the incidence of cesarean delivery between
the two groups remained nonsignificant (odds ratio 1.85; 95% confidence interval 0.97
to 3.53). Women with cerclage in the current pregnancy do not have a higher incidence
of cesarean delivery secondary to arrest of labor.
KEYWORDS
Cerclage - cesarean delivery - labor arrest
REFERENCES
- 1
Osterman MJK, Martin J A, Menacker F.
Expanded health data from the new birth certificate, 2006.
Natl Vital Stat Rep.
2009;
58
1-24
- 2
Abdelhak Y E, Aronov R, Roque H, Young B K.
Management of cervical cerclage at term: remove the suture in labor?.
J Perinat Med.
2000;
28
453-457
- 3
Barford DAG, Rosen M G.
Cervical incompetence: diagnosis and outcome.
Obstet Gynecol.
1984;
64
159-163
- 4
Hofmeister F J, Schwartz W R, Vondrak B F, Martens W. Experience at the Lutheran Hospital
of Milwaukee .
Suture reinforcement of the incompetent cervix.
Am J Obstet Gynecol.
1968;
101
58-65
- 5
Harger J H.
Comparison of success and morbidity in cervical cerclage procedures.
Obstet Gynecol.
1980;
56
543-548
- 6
Bisulli M, Suhag A, Arvon R, Seibel-Seamon J, Visintine J, Berghella V.
Interval to spontaneous delivery after elective removal of cerclage.
Am J Obstet Gynecol.
2009;
201
163
e1-4
- 7
Berghella V, Odibo A O, Tolosa J E.
Cerclage for prevention of preterm birth in women with a short cervix found on transvaginal
ultrasound examination: a randomized trial.
Am J Obstet Gynecol.
2004;
191
1311-1317
- 8
Owen J, Hankins G, Iams J D et al..
Multicenter randomized trial of cerclage for preterm birth prevention in high-risk
women with shortened midtrimester cervical length.
Am J Obstet Gynecol.
2009;
201
375
e1-e8
Priyadarshini KoduriM.D.
Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology
834 Chestnut Street, Suite 400, Philadelphia, PA 19107
eMail: koduri657@gmail.com
