Comparison of pregnancy outcomes after history-indicated and ultrasound-indicated cervical cerclage: A systematic review and meta-analysis
Year: 2025
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: OBJECTIVE: To compare maternal and neonatal outcomes in women with a previous history of pregnancy loss and/or preterm delivery who underwent ultrasound-indicated cerclage (UIC) or history-indicated cerclage (HIC). METHODS: PubMed, Web of Science, Scopus, and Embase databases were searched for observational studies and randomized controlled trials (RCT) from inception to 30 April 2024. Eligible studies should have compared the outcomes of women with singleton pregnancies who underwent UIC or HIC. STATA version 15.0 was employed, and the analysis was done using a random effects model and unadjusted effect sizes from the included studies. RESULTS: Of 25 included studies (n = 3909), most (n = 18) were retrospective cohort studies. Compared to women who underwent HIC, UIC was associated with higher risk of having a preterm birth (<37 weeks of gestation) (OR 1.48, 95% CI: 1.17, 1.88; N = 15), low birth weight (<2500g) (OR 1.78, 95% CI: 1.32, 2.41; N = 6) and admission to neonatal intensive care unit (OR 1.70, 95% CI: 1.27, 2.27; N = 6,). Women with UIC also had a higher risk of chorioamnionitis (OR 2.34, 95% CI: 1.36, 4.04; N = 4). The risk of having a low APGAR score (5-minute score of less than 7), fetal death and preterm premature rupture of membrane (PPROM) was comparable among the two groups. CONCLUSION: Our results demonstrate that UIC is associated with higher risks of adverse pregnancy outcomes compared to HIC. However, our evidence emanates from observational studies and is prone to biases, particularly because the findings were unadjusted for potential confounders. More clinical trials are needed to confirm our observations. SYSTEMATIC REVIEW PROTOCOL REGISTRATION: PROSPERO CRD42024544181.
Source: PLoS ONE
Authors: Jiamei Wang, Ling Zhu, Chunyan Xu, Wenjun Wu, Xuya Shen
Institution: Huzhou Women and Children's Hospital
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,382
OpenAlex ID: W4413137655