History-indicated cervical cerclage in management of twin pregnancy.
Adult
Case-Control Studies
Cerclage, Cervical
/ adverse effects
Cervix Uteri
/ physiopathology
Female
Gestational Age
Humans
Infant, Low Birth Weight
Infant, Newborn
Infant, Newborn, Diseases
/ epidemiology
Intensive Care Units, Neonatal
/ statistics & numerical data
Pregnancy
Pregnancy Outcome
Pregnancy Trimester, First
/ physiology
Pregnancy, Twin
/ statistics & numerical data
Premature Birth
/ surgery
Retrospective Studies
Stillbirth
/ epidemiology
Uterine Cervical Incompetence
/ epidemiology
cervical cerclage
cervical insufficiency
history-indicated
multiple gestation
preterm delivery
twins
Journal
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
ISSN: 1469-0705
Titre abrégé: Ultrasound Obstet Gynecol
Pays: England
ID NLM: 9108340
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
17
10
2018
revised:
20
11
2018
accepted:
06
12
2018
pubmed:
15
12
2018
medline:
17
3
2020
entrez:
15
12
2018
Statut:
ppublish
Résumé
Cervical cerclage, when performed in twin gestation, has been reported to be associated with poor outcome. However, the role of first-trimester history-indicated cerclage among women with a twin pregnancy and a history of preterm birth has not been evaluated. The aim of this study was to assess pregnancy outcomes among women with a twin pregnancy who underwent first-trimester history-indicated cervical cerclage compared with outcomes in those managed expectantly. This was a retrospective matched case-control study. The study group comprised all women with a twin pregnancy who had undergone first-trimester history-indicated cerclage during the period 2006 to 2017 at Hadassah-Hebrew University Medical Center. A control group of women with a twin pregnancy who were managed expectantly was established by matching age, history of spontaneous preterm birth (20-36 weeks' gestation) and year of delivery. Pregnancy and delivery characteristics and neonatal outcomes were compared between the two groups. Data from 82 women with a twin gestation were analyzed, of whom 41 underwent first-trimester history-indicated cerclage and 41 were matched controls who were managed expectantly. Gestational age at delivery was higher in the cerclage group than in those managed expectantly (median 35 vs 30 weeks; P < 0.0001). Rates of spontaneous preterm birth before 24 weeks (2.4% vs 19.5%; odds ratio (OR), 0.10 (95% CI, 0.01-0.87); P = 0.03), before 28 weeks (12.2% vs 34.1%; OR, 0.27 (95% CI, 0.09-0.84); P = 0.03), before 32 weeks (22.0% vs 56.1%; OR, 0.22 (95% CI, 0.08-0.58); P = 0.003) and before 34 weeks (34.1% vs 82.9%; OR, 0.11 (95% CI, 0.04-0.30); P < 0.0001) were significantly lower in the cerclage group than in the control group. Median birth weight was higher in the cerclage group (2072 g vs 1750 g; P = 0.003), with lower rates of low birth weight (< 2500 g) (65.0% vs 89.4%; P = 0.001) and very low birth weight (< 1500 g) (21.3% vs 37.9%; P = 0.03) than in the group managed expectantly. Rates were also lower in the cerclage group for stillbirth, admission to the neonatal intensive care unit, respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis, sepsis, neonatal mortality and composite adverse neonatal outcome. History-indicated cerclage performed in the first trimester, as compared with expectant management, in women with a twin pregnancy had an overall positive effect on pregnancy and neonatal outcomes. These findings suggest the need for adequate randomized trials on cerclage placement in this subset of women. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
517-523Informations de copyright
Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
Références
Hamilton BE, Hoyert DL, Martin JA, Strobino DM, Guyer B. Annual summary of vital statistics: 2010-2011. Pediatrics 2013; 131: 548-558.
March of Dimes, The Partnership for Maternal, Newborn and Child Health, Save the Children, World Health Organization. Born Too Soon: The Global Action Report on Preterm Birth. Howson CP, Kinney MV, Lawn JE (eds). World Health Organization: Geneva, 2012.
Chauhan SP, Scardo JA, Hayes E, Abuhamad AZ, Berghella V. Twins: prevalence, problems, and preterm births. Am J Obstet Gynecol 2010; 203: 305-315.
Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet 2008; 371: 75-84.
Makrydimas G, Sotiriadis A. Prediction of preterm birth in twins. Best Pract Res Clin Obstet Gynaecol 2014; 28: 265-272.
Parilla BV, Haney EI, Macgregor SN. The prevalence and timing of cervical cerclage placement in multiple gestations. Int J Gynaecol Obstet 2003; 80: 123-127.
Aboulghar M, Islam Y. Twin and Preterm Labor: Prediction and Treatment. Curr Obstet Gynecol Rep 2013; 2: 232-239.
Saccone G, Rust O, Althuisius S, Roman A, Berghella V. Cerclage for short cervix in twin pregnancies: systematic review and meta-analysis of randomized trials using individual patient-level data. Acta Obstet Gynecol Scand 2015; 94: 352-358.
Berghella V, Roman A. Cerclage in twins: we can do better! Am J Obstet Gynecol 2014; 211: 5-6.
Rafael TJ, Berghella V, Alfirevic Z. Cervical stitch (cerclage) for preventing preterm birth in multiple pregnancy. Cochrane Database Syst Rev 2014; 9: CD009166.
American College of Obstetricians and Gynecologists. ACOG practice bulletin no.142: Cerclage for the management of cervical insufficiency. Obstet Gynecol 2014; 123: 372-379.
Royal College of Obstetricians and Gynaecologists (RCOG). Cervical Cerclage: Green-Top Guideline No. 60. RCOG Press: London, UK, 2011.
Brown R, Gagnon R, Delisle MF; Maternal Fetal Medicine Committee. Cervical insufficiency and cervical cerclage. J Obstet Gynaecol Can 2013; 35: 1115-1127.
McDonald IA. Incompetent cervix as a cause of recurrent abortion. J Obstet Gynecol Br Commonw 1963; 70: 105-109.
International Committee for the Classification of Retinopathy of Prematurity. The International Classification of Retinopathy of Prematurity revisited. Arch Ophthalmol 2005; 123: 991-999.
Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall R, Barton L, Brotherton T. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann Surg 1978; 187: 1-7.
Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr 1978; 92: 529-534.
Final report of the Medical Research Council/Royal College of Obstetricians and Gynaecologists multicentre randomised trial of cervical cerclage. MRC/RCOG Working Party on Cervical Cerclage. Br J Obstet Gynaecol 1993; 100: 516-523.
American College of Obstetricians and Gynecologists. ACOG Practice Bulletin. Cervical insufficiency. Obstet Gynecol 2003; 102: 1091-1099.
Fox NS, Gelber SE, Kalish RB, Chasen ST. History-indicated cerclage: practice patterns of maternal-fetal medicine specialists in the USA. J Perinat Med 2008; 36: 513-517.
Drassinower D, Poggi SH, Landy HJ, Gilo N, Benson JE, Ghidini A. Perioperative complications of history-indicated and ultrasound-indicated cervical cerclage. Am J Obstet Gynecol 2011; 205: 53.e1-5.
Roman AS, Saltzman DH, Fox N. Prophylactic cerclage in the management of twin pregnancies. Am J Perinatol 2013; 30: 751-754.
Weekes AR, Menzies DN, de Boer CH. The relative efficacy of bed rest, cervical suture, and no treatment in the management of twin pregnancy. Br J Obstet Gynaecol 1977; 84: 161-164.
Dor J, Shalev J, Mashiach S, Blankstein J, Serr DM. Elective cervical suture of twin pregnancies diagnosed ultrasonically in the first trimester following induced ovulation. Gynecol Obstet Invest 1982; 13: 55-60.
Seki H, Kuromaki K, Takeda S, Kinoshita K. Prophylactic cervical cerclage for the prevention of early premature delivery in nulliparous women with twin pregnancies. J Obstet Gynaecol Res 2000; 26: 151-152.
Ehsanipoor RM, Seligman NS, Saccone G, Szymanski LM, Wissinger C, Werner EF, Berghella V. Physical examination-indicated cerclage: a systematic review and meta-analysis. Obstet Gynecol 2015; 126: 125-135.
Roman A, Suhag A, Berghella V. Cerclage: indications and patient counseling. Clin Obstet Gynecol 2016; 59: 264-269.
Society for Maternal-Fetal Medicine. Choosing Wisely - Five Things Physicians and Patients Should Question. February 2014. http://www.choosingwisely.org/societies/society-for-maternal-fetal-medicine/ [Accessed 17 September 2018].
Klein K, Rode L, Nicolaides KH, Krampl-Bettelheim E, Tabor A; PREDICT Group. Vaginal micronized progesterone and risk of preterm delivery in high-risk twin pregnancies: secondary analysis of a placebo-controlled randomized trial and meta-analysis. Ultrasound Obstet Gynecol 2011; 38: 281-287.
Combs CA, Garite TJ, Maurel K, Cebrik D; Obstetrix Collaborative Research Network. 17-hydroxyprogesterone caproate for women with history of preterm birth in a prior pregnancy and twins in the current pregnancy. Am J Obstet Gynecol 2012; 206: S213.
McIntosh J, Feltovich H, Berghella V, Manuck T. The role of routine cervical length screening in selected high- and low-risk women for preterm birth prevention. Am J Obstet Gynecol 2016; 215: B2- B7.