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FIGO good practice recommendations on cervical cerclage for prevention of preterm birth

Cervical cerclage is an intervention which when given to the right women can prevent preterm birth and second‐trimester fetal losses. A history‐indicated cerclage should be offered to women who have had three or more preterm deliveries and/or mid‐trimester losses. An ultrasound‐indicated cerclage sh...

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Autores principales: Shennan, Andrew, Story, Lisa, Jacobsson, Bo, Grobman, William A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9291060/
https://www.ncbi.nlm.nih.gov/pubmed/34520055
http://dx.doi.org/10.1002/ijgo.13835
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author Shennan, Andrew
Story, Lisa
Jacobsson, Bo
Grobman, William A.
author_facet Shennan, Andrew
Story, Lisa
Jacobsson, Bo
Grobman, William A.
author_sort Shennan, Andrew
collection PubMed
description Cervical cerclage is an intervention which when given to the right women can prevent preterm birth and second‐trimester fetal losses. A history‐indicated cerclage should be offered to women who have had three or more preterm deliveries and/or mid‐trimester losses. An ultrasound‐indicated cerclage should be offered to women with a cervical length <25 mm if they have had one or more spontaneous preterm birth and/or mid‐trimester loss. In high‐risk women who have not had a previous mid‐trimester loss or preterm birth, an ultrasound‐indicated cerclage does not have a clear benefit in women with a short cervix. However, for twins, the advantage seems more likely at shorter cervical lengths (<15 mm). In women who present with exposed membranes prolapsing through the cervical os, a rescue cerclage can be considered on an individual case basis, taking into account the high risk of infective morbidity to mother and baby. An abdominal cerclage can be offered in women who have had a failed cerclage (delivery before 28 weeks after a history or ultrasound‐indicated [but not rescue] cerclage). If preterm birth has not occurred, removal is considered at 36–37 weeks in women anticipating a vaginal delivery.
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spelling pubmed-92910602022-07-20 FIGO good practice recommendations on cervical cerclage for prevention of preterm birth Shennan, Andrew Story, Lisa Jacobsson, Bo Grobman, William A. Int J Gynaecol Obstet Special Articles Cervical cerclage is an intervention which when given to the right women can prevent preterm birth and second‐trimester fetal losses. A history‐indicated cerclage should be offered to women who have had three or more preterm deliveries and/or mid‐trimester losses. An ultrasound‐indicated cerclage should be offered to women with a cervical length <25 mm if they have had one or more spontaneous preterm birth and/or mid‐trimester loss. In high‐risk women who have not had a previous mid‐trimester loss or preterm birth, an ultrasound‐indicated cerclage does not have a clear benefit in women with a short cervix. However, for twins, the advantage seems more likely at shorter cervical lengths (<15 mm). In women who present with exposed membranes prolapsing through the cervical os, a rescue cerclage can be considered on an individual case basis, taking into account the high risk of infective morbidity to mother and baby. An abdominal cerclage can be offered in women who have had a failed cerclage (delivery before 28 weeks after a history or ultrasound‐indicated [but not rescue] cerclage). If preterm birth has not occurred, removal is considered at 36–37 weeks in women anticipating a vaginal delivery. John Wiley and Sons Inc. 2021-09-14 2021-10 /pmc/articles/PMC9291060/ /pubmed/34520055 http://dx.doi.org/10.1002/ijgo.13835 Text en © 2021 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Special Articles
Shennan, Andrew
Story, Lisa
Jacobsson, Bo
Grobman, William A.
FIGO good practice recommendations on cervical cerclage for prevention of preterm birth
title FIGO good practice recommendations on cervical cerclage for prevention of preterm birth
title_full FIGO good practice recommendations on cervical cerclage for prevention of preterm birth
title_fullStr FIGO good practice recommendations on cervical cerclage for prevention of preterm birth
title_full_unstemmed FIGO good practice recommendations on cervical cerclage for prevention of preterm birth
title_short FIGO good practice recommendations on cervical cerclage for prevention of preterm birth
title_sort figo good practice recommendations on cervical cerclage for prevention of preterm birth
topic Special Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9291060/
https://www.ncbi.nlm.nih.gov/pubmed/34520055
http://dx.doi.org/10.1002/ijgo.13835
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