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Advanced Cervical Change: Cerclage Beats Bed Rest.
KAMUELA, HAWAII -- Patients who received cerclage for advanced cervical effacement and/or dilation delivered their babies nearly 5 weeks closer to term than those treated with bed rest in an historical cohort analysis at Oregon Health Sciences University, Portland.
Infants born to mothers who received cerclage, rather than conservative management, weighed an average of 1,722 g, compared with 811 g, and the newborns stayed in the neonatal ICU an average of 31 days, compared with 75 days, Dr. Miles J. Novy said at the annual meeting of the Pacific Coast Obstetrical and Gynecological Society.
Physician choice rather than a randomized assignment determined what management course would be followed for 35 patients determined by transvaginal ultrasound or examination to have a cervical dilatation of 2-5 cm and/or effacement of at least 60% with membranes visible or protruding at the external os during the second trimester, said Dr. Novy of the university.
Despite the potential for selection bias in nonrandomized trials, patients who received cerclage and those assigned to bed rest were similar in demographic characteristics, severity of cervical changes at presentation, pregnancy complications, and prescribed use of antibiotics and anti-inflammatory drugs.
"The results suggest treatment with cerclage for patients with advanced cervical changes is superior to conservative management, even in the presence of antibiotics and anti-inflammatory agents," he said.
Cerclage also appeared to benefit an additional 35 study participants diagnosed with early cervical changes by ...
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Source: HighBeam Research, Advanced Cervical Change: Cerclage Beats Bed Rest.