Cerclage Location and Gestational Age at Delivery
Abstract Objective Multiple authors have suggested cerclage position is a determinant of “success.” We assessed the interaction between cervical length (CL), cerclage height (cerH), proximal residual length (PRL), gestational age at delivery, and rate of delivery ≤ 34 weeks, in this stu...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Thieme Medical Publishers, Inc.
2019-04-01
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| Series: | American Journal of Perinatology Reports |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1688778 |
| _version_ | 1818622899523682304 |
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| author | Fatima Estrada Scarlett Karakash Terry SeeToe Jeremy Weedon Howard Minkoff |
| author_facet | Fatima Estrada Scarlett Karakash Terry SeeToe Jeremy Weedon Howard Minkoff |
| author_sort | Fatima Estrada |
| collection | DOAJ |
| description | Abstract
Objective Multiple authors have suggested cerclage position is a determinant of “success.” We assessed the interaction between cervical length (CL), cerclage height (cerH), proximal residual length (PRL), gestational age at delivery, and rate of delivery ≤ 34 weeks, in this study.
Study Design Present study is a retrospective cohort study of all cerclages placed at Maimonides Medical Center from 2006 to 2016. Outcomes: gestational age at delivery and delivery before 34 weeks; predictors: PRL, cerH, CL; and indications for cerclage: history (Hx), physical exam (PE), and ultrasound (US) indicated cerclage. A general linear model was used to predict power-transformed age at delivery from cerH, CL, and indication for cerclage. Subanalyses by indication were conducted. Logistic regression was used for delivery ≤ 34 weeks.
Results The cerH by indication did not reach statistical significance (p = 0.090). When stratified by indications, the effect of cerH on age at delivery was apparent for Hx (adjusted R
2 = 0.18, p < 0.001) and PE (adjusted R
2 = 0.43, p = 0.004) cerclages but not for US cerclages (adjusted R
2 = 0.08, p = 0.206). Logistic regression predicting delivery ≤ 34 weeks (n = 29) produced similar results.
Conclusions For Hx and PE indicated cerclages, the location of the stitch may influence the timing of delivery. Specifically, the higher the cerclage, the more advanced the gestational age at delivery. |
| first_indexed | 2024-12-16T18:32:30Z |
| format | Article |
| id | doaj.art-bf42a5c44a84472fb188ffadba2eb6b4 |
| institution | Directory Open Access Journal |
| issn | 2157-6998 2157-7005 |
| language | English |
| last_indexed | 2024-12-16T18:32:30Z |
| publishDate | 2019-04-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | American Journal of Perinatology Reports |
| spelling | doaj.art-bf42a5c44a84472fb188ffadba2eb6b42022-12-21T22:21:16ZengThieme Medical Publishers, Inc.American Journal of Perinatology Reports2157-69982157-70052019-04-010902e195e19910.1055/s-0039-1688778Cerclage Location and Gestational Age at DeliveryFatima Estrada0Scarlett Karakash1Terry SeeToe2Jeremy Weedon3Howard Minkoff4Departments of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New YorkDivision of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, Stanford University, Stanford, CaliforniaDivision of Research, State University of New York, New York, New YorkDivision of Research, State University of New York, New York, New YorkDepartments of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New YorkAbstract Objective Multiple authors have suggested cerclage position is a determinant of “success.” We assessed the interaction between cervical length (CL), cerclage height (cerH), proximal residual length (PRL), gestational age at delivery, and rate of delivery ≤ 34 weeks, in this study. Study Design Present study is a retrospective cohort study of all cerclages placed at Maimonides Medical Center from 2006 to 2016. Outcomes: gestational age at delivery and delivery before 34 weeks; predictors: PRL, cerH, CL; and indications for cerclage: history (Hx), physical exam (PE), and ultrasound (US) indicated cerclage. A general linear model was used to predict power-transformed age at delivery from cerH, CL, and indication for cerclage. Subanalyses by indication were conducted. Logistic regression was used for delivery ≤ 34 weeks. Results The cerH by indication did not reach statistical significance (p = 0.090). When stratified by indications, the effect of cerH on age at delivery was apparent for Hx (adjusted R 2 = 0.18, p < 0.001) and PE (adjusted R 2 = 0.43, p = 0.004) cerclages but not for US cerclages (adjusted R 2 = 0.08, p = 0.206). Logistic regression predicting delivery ≤ 34 weeks (n = 29) produced similar results. Conclusions For Hx and PE indicated cerclages, the location of the stitch may influence the timing of delivery. Specifically, the higher the cerclage, the more advanced the gestational age at delivery.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1688778preterm deliverycervical cerclagecervical lengthcerclage heightproximal residual lengthhistory indicated cerclagephysical exam indicated cerclageultrasound indicated cerclage |
| spellingShingle | Fatima Estrada Scarlett Karakash Terry SeeToe Jeremy Weedon Howard Minkoff Cerclage Location and Gestational Age at Delivery American Journal of Perinatology Reports preterm delivery cervical cerclage cervical length cerclage height proximal residual length history indicated cerclage physical exam indicated cerclage ultrasound indicated cerclage |
| title | Cerclage Location and Gestational Age at Delivery |
| title_full | Cerclage Location and Gestational Age at Delivery |
| title_fullStr | Cerclage Location and Gestational Age at Delivery |
| title_full_unstemmed | Cerclage Location and Gestational Age at Delivery |
| title_short | Cerclage Location and Gestational Age at Delivery |
| title_sort | cerclage location and gestational age at delivery |
| topic | preterm delivery cervical cerclage cervical length cerclage height proximal residual length history indicated cerclage physical exam indicated cerclage ultrasound indicated cerclage |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1688778 |
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