Cervical length following cerclage as a predictor of spontaneous preterm birth.

IF 2.5 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Archives of Gynecology and Obstetrics Pub Date : 2026-05-08 DOI:10.1007/s00404-026-08453-9

Maya Frank Wolf, Liron Kinog, Ruba Tuma, Lior Lowenstein, Marwan Odeh, Inshirah Sgayer

{"title":"Cervical length following cerclage as a predictor of spontaneous preterm birth.","authors":"Maya Frank Wolf, Liron Kinog, Ruba Tuma, Lior Lowenstein, Marwan Odeh, Inshirah Sgayer","doi":"10.1007/s00404-026-08453-9","DOIUrl":null,"url":null,"abstract":"Objective: We aimed to evaluate the association between serial transvaginal cervical length measurements following McDonald cerclage and spontaneous preterm birth (PTB).Methods: This retrospective study included singleton pregnancies with cerclage performed during 2010-2024. Cerclage was placed prophylactically (n = 109) based on obstetric history, or emergently (n = 46) due to ultrasound findings. Cervical length was measured by transvaginal ultrasound before and after cerclage, and at 2-week intervals until 32 weeks.Results: For the prophylactic group, the median cervical length was shorter among those who delivered PTB < 37 weeks (n = 23) than term: at 21-22 + 6 weeks (2.5 vs. 3.9 cm, p = 0.042), 23-24 + 6 weeks (2.0 vs. 3.4 cm, p = 0.016), 25-26 + 6 weeks (3.0 vs. 3.8 cm, p = 0.042), and 31-32 + 6 weeks (2.4 vs. 3.4 cm, p = 0.015). In multivariable analysis adjusted for history of PTB, progesterone use, and gestational age at cerclage placement, shorter cervical length, at 23-24 + 6 weeks (adjusted odds ratio [aOR] 4.13, 95% confidence interval [CI] 1.23-13.89, p = 0.021) and at 25-26 + 6 weeks (aOR 3.39, 95% CI 1.08-10.64, p = 0.037), was independently associated with PTB < 37 weeks. Cervical length at 25-26 + 6 weeks was associated with PTB < 32 weeks (aOR 4.76, 95% CI 1.20-19.60, p = 0.027). For the emergency group, the median cervical length was shorter among those who delivered < 32 weeks than later, at 23-24 + 6 weeks (1.4 vs. 3.2 cm, p = 0.049) and 25-26 weeks (1.5 vs. 2.3 cm, p = 0.041).Conclusion: Serial cervical length monitoring after cerclage provides a clinically relevant prediction of spontaneous PTB.","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.5000,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Gynecology and Obstetrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00404-026-08453-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: We aimed to evaluate the association between serial transvaginal cervical length measurements following McDonald cerclage and spontaneous preterm birth (PTB).

Methods: This retrospective study included singleton pregnancies with cerclage performed during 2010-2024. Cerclage was placed prophylactically (n = 109) based on obstetric history, or emergently (n = 46) due to ultrasound findings. Cervical length was measured by transvaginal ultrasound before and after cerclage, and at 2-week intervals until 32 weeks.

Results: For the prophylactic group, the median cervical length was shorter among those who delivered PTB < 37 weeks (n = 23) than term: at 21-22 + 6 weeks (2.5 vs. 3.9 cm, p = 0.042), 23-24 + 6 weeks (2.0 vs. 3.4 cm, p = 0.016), 25-26 + 6 weeks (3.0 vs. 3.8 cm, p = 0.042), and 31-32 + 6 weeks (2.4 vs. 3.4 cm, p = 0.015). In multivariable analysis adjusted for history of PTB, progesterone use, and gestational age at cerclage placement, shorter cervical length, at 23-24 + 6 weeks (adjusted odds ratio [aOR] 4.13, 95% confidence interval [CI] 1.23-13.89, p = 0.021) and at 25-26 + 6 weeks (aOR 3.39, 95% CI 1.08-10.64, p = 0.037), was independently associated with PTB < 37 weeks. Cervical length at 25-26 + 6 weeks was associated with PTB < 32 weeks (aOR 4.76, 95% CI 1.20-19.60, p = 0.027). For the emergency group, the median cervical length was shorter among those who delivered < 32 weeks than later, at 23-24 + 6 weeks (1.4 vs. 3.2 cm, p = 0.049) and 25-26 weeks (1.5 vs. 2.3 cm, p = 0.041).

Conclusion: Serial cervical length monitoring after cerclage provides a clinically relevant prediction of spontaneous PTB.

查看原文本刊更多论文

环扎术后宫颈长度作为自发性早产的预测因子。

目的：我们旨在评估麦克唐纳环切术后连续经阴道宫颈长度测量与自发性早产（PTB）之间的关系。方法：本回顾性研究纳入2010-2024年间单胎妊娠结扎术。根据产科病史预防性（n = 109）进行环扎术，或根据超声检查结果紧急（n = 46）进行环扎术。在结扎前后，每隔2周至32周，经阴道超声测量宫颈长度。结果：预防组分娩PTB的中位宫颈长度较短。结论：环切术后连续监测宫颈长度可为自发性PTB提供临床相关预测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Archives of Gynecology and Obstetrics 医学-妇产科学

CiteScore

4.70

自引率

15.40%

发文量

493

审稿时长

1 months

期刊介绍： Founded in 1870 as "Archiv für Gynaekologie", Archives of Gynecology and Obstetrics has a long and outstanding tradition. Since 1922 the journal has been the Organ of the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe. "The Archives of Gynecology and Obstetrics" is circulated in over 40 countries world wide and is indexed in "PubMed/Medline" and "Science Citation Index Expanded/Journal Citation Report". The journal publishes invited and submitted reviews; peer-reviewed original articles about clinical topics and basic research as well as news and views and guidelines and position statements from all sub-specialties in gynecology and obstetrics.