TY - JOUR
T1 - Ultrasound-predicated versus history-predicated cerclage in women at risk of cervical insufficiency
T2 - A systematic review
AU - Blikman, Maria J.C.
AU - Le, Thuy My
AU - Bruinse, Hein W.
AU - Van Der Heijden, Geert J.M.G.
N1 - Copyright:
Copyright 2010 Elsevier B.V., All rights reserved.
PY - 2008/12
Y1 - 2008/12
N2 - The aim of this systematic review was to compare pregnancy outcomes and cerclage-related complications of ultrasound-predicated versus history-predicated cerclage in patients at risk of cervical insufficiency due to a history of preterm delivery (PTD). A structured search was performed in PubMed, Embase, and the Cochrane Library to identify potentially relevant articles from January 1980 through July 2007. Studies were included if ultrasound-predicated cerclage was compared to historypredicated cerclage in women with a singleton gestation and a history of PTD. The PubMed, Embase, and Cochrane search yielded 537,643, and 42 articles, respectively. In addition, 1194 "Related articles" (PubMed) and 87 "Cited in/cited by" (ISI-WOS) from all potentially relevant articles were assessed. After critical evaluation for relevance and quality, 6 articles remained. Five of the 6 included studies showed no differences in pregnancy outcome (PTD or pregnancy loss <24 weeks) between the ultrasoundpredicated and the history-predicated cerclage groups. In 1 prospective cohort study, PTD below 30 weeks was significantly lower in the ultrasound group. The included studies showed that in the ultrasound group, 40% to 68% of the patients did not require cerclage. The majority of studies provided insufficient data to draw conclusions regarding cerclage-related complications. In conclusion, using ultrasound to identify women at risk of cervical insufficiency because of a history of PTD reduces cerclage rates and results in similar pregnancy outcomes as cerclage placement on the basis of history alone.
AB - The aim of this systematic review was to compare pregnancy outcomes and cerclage-related complications of ultrasound-predicated versus history-predicated cerclage in patients at risk of cervical insufficiency due to a history of preterm delivery (PTD). A structured search was performed in PubMed, Embase, and the Cochrane Library to identify potentially relevant articles from January 1980 through July 2007. Studies were included if ultrasound-predicated cerclage was compared to historypredicated cerclage in women with a singleton gestation and a history of PTD. The PubMed, Embase, and Cochrane search yielded 537,643, and 42 articles, respectively. In addition, 1194 "Related articles" (PubMed) and 87 "Cited in/cited by" (ISI-WOS) from all potentially relevant articles were assessed. After critical evaluation for relevance and quality, 6 articles remained. Five of the 6 included studies showed no differences in pregnancy outcome (PTD or pregnancy loss <24 weeks) between the ultrasoundpredicated and the history-predicated cerclage groups. In 1 prospective cohort study, PTD below 30 weeks was significantly lower in the ultrasound group. The included studies showed that in the ultrasound group, 40% to 68% of the patients did not require cerclage. The majority of studies provided insufficient data to draw conclusions regarding cerclage-related complications. In conclusion, using ultrasound to identify women at risk of cervical insufficiency because of a history of PTD reduces cerclage rates and results in similar pregnancy outcomes as cerclage placement on the basis of history alone.
UR - http://www.scopus.com/inward/record.url?scp=64149100192&partnerID=8YFLogxK
U2 - 10.1097/OGX.0b013e318189634e
DO - 10.1097/OGX.0b013e318189634e
M3 - Review article
C2 - 19017416
AN - SCOPUS:64149100192
SN - 0029-7828
VL - 63
SP - 803
EP - 812
JO - Obstetrical and Gynecological Survey
JF - Obstetrical and Gynecological Survey
IS - 12
ER -