Cerclage for the prevention of preterm birth in high risk women receiving intramuscular 17-α-hydroxyprogesterone caproate

Jeff M. Szychowski, Vincenzo Berghella, John Owen, Gary Hankins, Jay D. Iams, Jeanne S. Sheffield, Annette Perez-Delboy, Deborah A. Wing, Edwin R. Guzman

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Objective: To assess cerclage benefit in women with short cervix also receiving 17-α-hydroxyprogesterone caproate (17P) to prevent recurrent preterm birth (PTB). Methods: Secondary analysis of a multicenter trial of ultrasound-indicated cerclage for shortened cervical length (CL). Women with prior spontaneous PTB at 16-33 6/7 weeks, singleton gestation and CL < 25-mm between 16 and 22 6/7 weeks were counseled on use of 17P and randomized to cerclage or no cerclage. Outcomes of women who received 17P were analyzed by randomization group. Primary outcome was PTB < 35 weeks. Results: 99 women received 17P: 47 cerclage; 52 no cerclage. Rates of PTB < 35 weeks were similar, 30% for cerclage and 38% for no cerclage (aOR 0.64 (0.27-1.52)). In women with CL < 15-mm, PTB < 35 weeks was reduced for the cerclage group (17% vs. 75%, p = 0.02). However, this difference was nullified after controlling for total progesterone doses received (p = 0.40). Conclusions: Cerclage was shown not to offer additional benefit for the prevention of recurrent PTB in women with short CL < 25-mm receiving 17P, but the sample size is insufficient for a definite conclusion given the 36% nonsignificant decrease in the odds of PTB < 35 weeks. Cerclage may further offer substantial benefit to women with very short CL < 15-mm and further study is needed.

Original languageEnglish (US)
Pages (from-to)2686-2689
Number of pages4
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume25
Issue number12
DOIs
StatePublished - Dec 1 2012

Keywords

  • Cerclage
  • Preterm birth
  • Progesterone
  • Short cervical length

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Fingerprint Dive into the research topics of 'Cerclage for the prevention of preterm birth in high risk women receiving intramuscular 17-α-hydroxyprogesterone caproate'. Together they form a unique fingerprint.

  • Cite this

    Szychowski, J. M., Berghella, V., Owen, J., Hankins, G., Iams, J. D., Sheffield, J. S., Perez-Delboy, A., Wing, D. A., & Guzman, E. R. (2012). Cerclage for the prevention of preterm birth in high risk women receiving intramuscular 17-α-hydroxyprogesterone caproate. Journal of Maternal-Fetal and Neonatal Medicine, 25(12), 2686-2689. https://doi.org/10.3109/14767058.2012.717128