Postoperative cervical length to predict success of repeat cerclage in singleton pregnancies with prolapsed membranes after prior cerclage
BackgroundThis study aimed to evaluate the outcome of repeat cerclage (RC) in singleton pregnancies with prolapsed membranes following a prior cerclage and analyze predictive factors for delivery at ≥26 weeks of gestation following RC.Materials and methodsPatients who underwent RC between 2010 and 2...
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| Format: | Article |
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Frontiers Media S.A.
2023-08-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1248321/full |
| _version_ | 1797740078199472128 |
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| author | Suyeon Park Keun-Young Lee Ji-Eun Song |
| author_facet | Suyeon Park Keun-Young Lee Ji-Eun Song |
| author_sort | Suyeon Park |
| collection | DOAJ |
| description | BackgroundThis study aimed to evaluate the outcome of repeat cerclage (RC) in singleton pregnancies with prolapsed membranes following a prior cerclage and analyze predictive factors for delivery at ≥26 weeks of gestation following RC.Materials and methodsPatients who underwent RC between 2010 and 2020 at the Hallym University Medical Center were reviewed. Women with singleton pregnancies with prolapsed membranes following prior cerclage were candidates for RC. We analyzed the characteristics, pregnancy outcomes, perioperative clinical and laboratory findings, and postoperative cervical length (CL) to identify the factors for predicting delivery at ≥26 weeks following RC.ResultsThirty-five women with RC were identified; the median gestational age (GA) at a prior cerclage was 14 weeks, the average GA at RC was 21 + 3 weeks, and the median GA at delivery following RC was 26 + 2 weeks. Patients were divided into two groups based on their delivery status at 26 weeks: 17 women delivered at <26 weeks (range, 18 + 4–25 + 6 weeks) (Group A) and 18 women delivered at ≥26 weeks (range, 26 + 2–40 + 3 weeks) (Group B). The median GA at delivery in group A was 22 + 4 weeks, whereas that in group B was 33 + 4 weeks (p < 0.001). No differences in preoperative clinical and laboratory findings were observed between the two groups. However, the postoperative CL in group A was significantly shorter than that in group B (12 mm vs. 21.5 mm, p < 0.001). The ROC curve of postoperative CL predicting delivery at ≥26 weeks showed an AUC of 0.843; a CL of 20 mm showed a sensitivity of 61.1% and a specificity of 100%.ConclusionRC may prolong singleton pregnancies with prolapsed membranes following prior cerclage. A postoperative CL ≥20 mm may predict the success of RC. |
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| id | doaj.art-0f0c31062d90488987e73fd4309816e9 |
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| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-12T14:07:20Z |
| publishDate | 2023-08-01 |
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| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-0f0c31062d90488987e73fd4309816e92023-08-21T12:35:09ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-08-011010.3389/fmed.2023.12483211248321Postoperative cervical length to predict success of repeat cerclage in singleton pregnancies with prolapsed membranes after prior cerclageSuyeon Park0Keun-Young Lee1Ji-Eun Song2Department of Obstetrics and Gynecology, Inha University College of Medicine, Inha University Hospital, Incheon, Republic of KoreaDepartment of Obstetrics and Gynecology, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of KoreaDepartment of Obstetrics and Gynecology, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of KoreaBackgroundThis study aimed to evaluate the outcome of repeat cerclage (RC) in singleton pregnancies with prolapsed membranes following a prior cerclage and analyze predictive factors for delivery at ≥26 weeks of gestation following RC.Materials and methodsPatients who underwent RC between 2010 and 2020 at the Hallym University Medical Center were reviewed. Women with singleton pregnancies with prolapsed membranes following prior cerclage were candidates for RC. We analyzed the characteristics, pregnancy outcomes, perioperative clinical and laboratory findings, and postoperative cervical length (CL) to identify the factors for predicting delivery at ≥26 weeks following RC.ResultsThirty-five women with RC were identified; the median gestational age (GA) at a prior cerclage was 14 weeks, the average GA at RC was 21 + 3 weeks, and the median GA at delivery following RC was 26 + 2 weeks. Patients were divided into two groups based on their delivery status at 26 weeks: 17 women delivered at <26 weeks (range, 18 + 4–25 + 6 weeks) (Group A) and 18 women delivered at ≥26 weeks (range, 26 + 2–40 + 3 weeks) (Group B). The median GA at delivery in group A was 22 + 4 weeks, whereas that in group B was 33 + 4 weeks (p < 0.001). No differences in preoperative clinical and laboratory findings were observed between the two groups. However, the postoperative CL in group A was significantly shorter than that in group B (12 mm vs. 21.5 mm, p < 0.001). The ROC curve of postoperative CL predicting delivery at ≥26 weeks showed an AUC of 0.843; a CL of 20 mm showed a sensitivity of 61.1% and a specificity of 100%.ConclusionRC may prolong singleton pregnancies with prolapsed membranes following prior cerclage. A postoperative CL ≥20 mm may predict the success of RC.https://www.frontiersin.org/articles/10.3389/fmed.2023.1248321/fullrepeat cerclagesingleton pregnancypreterm birthcervical lengthprior cerclagemembrane bulging |
| spellingShingle | Suyeon Park Keun-Young Lee Ji-Eun Song Postoperative cervical length to predict success of repeat cerclage in singleton pregnancies with prolapsed membranes after prior cerclage Frontiers in Medicine repeat cerclage singleton pregnancy preterm birth cervical length prior cerclage membrane bulging |
| title | Postoperative cervical length to predict success of repeat cerclage in singleton pregnancies with prolapsed membranes after prior cerclage |
| title_full | Postoperative cervical length to predict success of repeat cerclage in singleton pregnancies with prolapsed membranes after prior cerclage |
| title_fullStr | Postoperative cervical length to predict success of repeat cerclage in singleton pregnancies with prolapsed membranes after prior cerclage |
| title_full_unstemmed | Postoperative cervical length to predict success of repeat cerclage in singleton pregnancies with prolapsed membranes after prior cerclage |
| title_short | Postoperative cervical length to predict success of repeat cerclage in singleton pregnancies with prolapsed membranes after prior cerclage |
| title_sort | postoperative cervical length to predict success of repeat cerclage in singleton pregnancies with prolapsed membranes after prior cerclage |
| topic | repeat cerclage singleton pregnancy preterm birth cervical length prior cerclage membrane bulging |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1248321/full |
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