Meta-analysis of cerclage for short cervix and prior prematurity

January 01, 0001

Meta-analysis of cerclage for short cervix and prior prematurity

These US authors conducted a meta-analysis to estimate to what extent cerclage prevents preterm birth and perinatal mortality and morbidity in women with previous preterm birth, singleton gestation, and short cervical length. They included randomized trials consistent with that purpose.

They found: "Patient-level data abstraction and analysis were accomplished by two independent investigators. Five trials met inclusion criteria. In women with a singleton gestation, previous spontaneous preterm birth, and cervical length less than 25 mm before 24 weeks of gestation, preterm birth before 35 weeks of gestation was 28.4% (71/250) in the cerclage compared with 41.3% (105/254) in the no cerclage groups (relative risk 0.70). Cerclage also significantly reduced preterm birth before 37, 32, 28, and 24 weeks of gestation. Composite perinatal mortality and morbidity were significantly reduced (15.6% in cerclage compared with 24.8% in no cerclage groups; relative risk 0.64)."

The authors concluded: "In women with previous spontaneous preterm birth, singleton gestation, and cervical length less than 25 mm, cerclage significantly prevents preterm birth and composite perinatal mortality and morbidity."

Cerclage is moderately effective in this population.

For the full abstract, click here.

Obstet Gynecol 117(3):663-671, March 2011
© 2011 to the American College of Obstetricians and Gynecologists
Cerclage for Short Cervix on Ultrasonography in Women With Singleton Gestations and Previous Preterm Birth: A Meta-Analysis. Vincenzo Berghella, Timothy J. Rafael, Jeff M. Szychowski, Orion A. Rust John Owen. Correspondence to Dr. Berghella:

Category: W. Pregnancy, Family Planning. Keywords: cerclage, preterm birth, ultrasonography, shortened cervix, meta- analysis of randomized controlled trials, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 3 May 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.