Work

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

Year: 2021

Type: article

Abstract: 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.

Source: International Journal of Gynecology & Obstetrics

DOI: 10.1002/ijgo.13835

Authors: Andrew Shennan, Lisa Story, Bo Jacobsson, William A. Grobman, the FIGO Working Group for Preterm Birth

Institutions: King's College London, Norwegian Institute of Public Health, Sahlgrenska University Hospital, University of Gothenburg, Northwestern University

Language: English

Topic: Preterm Birth and Chorioamnionitis

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,700