Cervical Cerclage vs. Pessary in Women with a Short Cervix on Ultrasound.

IF 3.1 3区医学 Q1 ACOUSTICS

Ultraschall in Der Medizin Pub Date : 2023-10-01 Epub Date: 2022-09-07 DOI:10.1055/a-1938-6042

Vasilios Pergialiotis, Alexandros Psarris, Panagiotis Antsaklis, Marianna Theodora, Aggeliki Papapanagiotou, Alexandros Rodolakis, Georgios Daskalakis

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引用次数: 1

Abstract

Purpose: In the present study we sought to compare the efficacy of cervical pessary to that of cerclage in terms of reducing preterm birth rates among women with a short (<25 mm) or ultra-short (<15 and <10 mm) cervix during the ultrasonographic second-trimester assessment.

Method: We retrospectively searched the hospital records for singleton pregnancies diagnosed with cervical insufficiency during the second trimester of pregnancy. The McDonald cerclage using a 5mm Mersilene tape was used in all women. An Arabin pessary was used uniformly. In all cases 80 mg of vaginal progesterone gel were administered daily until 37 weeks of gestation.

Results: Overall, 294 women (124 (42.2%) with a McDonald cerclage and 170 (57.8%) with placement of an Arabin pessary) were selected for analysis. Preterm birth rates <37 weeks were similar in both groups (C: 30/122 vs. P: 35:165, p=.581) as well as PTB <34 weeks (C: 16/122 vs. 15/150, p=.278). Admission to the NICU and need for CPAP were more prevalent in the cerclage group (p<.001). Analysis of cases with a cervix <15 mm and <10 mm indicated that preterm birth rates remained equal among the groups, while an increased risk of NICU admission was seen in cases with a cervical length <10 mm that were treated with cerclage.

Discussion and conclusion: Cervical pessary may be an alternative to cervical cerclage for women with second-trimester cervical shortening and its effect may persist even among cases with an ultra-short cervix. Future randomized trials are needed to ascertain these findings.

查看原文本刊更多论文

超声检查中短宫颈妇女的宫颈环扎术与子宫颈。

目的：在本研究中，我们试图比较子宫颈托和环扎术在降低妊娠期妇女早产率方面的疗效（方法：我们回顾性地检索了妊娠中期被诊断为宫颈功能不全的单胎妊娠的医院记录。所有妇女都使用了5毫米Mersilene胶带进行的McDonald环扎术。阿拉比恩子宫颈托使用均匀。在所有病例中，每天给药80毫克阴道孕酮凝胶，直到妊娠37周选择n例（124例（42.2%）用McDonald环扎术和170例（57.8%）用Arabin子宫颈栓）进行分析。早产率讨论和结论：对于妊娠中期宫颈缩短的妇女来说，子宫颈托可能是宫颈环扎术的一种替代方法，即使在宫颈超短的病例中，其效果也可能持续。未来需要进行随机试验来确定这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ultraschall in Der Medizin 医学-核医学

CiteScore

5.30

自引率

8.80%

发文量

228

审稿时长

6-12 weeks

期刊介绍： Ultraschall in der Medizin / European Journal of Ultrasound publishes scientific papers and contributions from a variety of disciplines on the diagnostic and therapeutic applications of ultrasound with an emphasis on clinical application. Technical papers with a physiological theme as well as the interaction between ultrasound and biological systems might also occasionally be considered for peer review and publication, provided that the translational relevance is high and the link with clinical applications is tight. The editors and the publishers reserve the right to publish selected articles online only. Authors are welcome to submit supplementary video material. Letters and comments are also accepted, promoting a vivid exchange of opinions and scientific discussions.