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Ultrasound Helpful in Choosing Cerclage Patients.
MAUI, HAWAII -- Using serial transvaginal ultrasounds to decide which pregnant patients should get a cerdage may limit the use of this procedure and lower costs without increasing the risk of preterm delivery, Dr. Manuel Porto said at a conference on ob.gyn. ultrasound sponsored by the University of California, Irvine.
He and his associates at the university routinely perform serial second-trimester ultrasounds when cerclage seems to be indicated, but the need for it is not entirely clear, he said.
Serial ultrasounds to monitor cervical length and funneling are helpful in patients with previous cone biopsies or laser manipulations of the cervix or histories of a single previous midtrimester loss, multiple borderline first- or second-trimester losses, or very early preterm deliveries. Cervical shortening, funneling, and induced funneling by pressing on the fundus are ultrasound markers of increased risk for preterm birth, a risk that can be decreased by cerclage.
More than half of the patients in Dr. Porto's practice who would have received an elective cerclage had they not been monitored by ultrasound were able to complete their pregnancy without a cerclage, said Dr. Porto, director of maternalfetal medicine at the university.
His anecdotal experience mirrors that of a 1998 study at the Robert Wood Johnson Medical School, New Brunswick, NJ. In that study 81 patients received an elective cerclage at around 13 weeks' gestation, and an additional 222 patients (26% of whom got a cerclage at around 20 weeks' gestation) were followed by transvaginal ultrasound.
Delivery occurred at an average ...
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Source: HighBeam Research, Ultrasound Helpful in Choosing Cerclage Patients.