BACKGROUND
Cervical cerclage is an effective intervention to prevent preterm birth among individuals
with a history of cervical insufficiency, individuals with a short cervix and history
of preterm birth, or individuals with second-trimester painless dilation. Although
cerclage reduces the mechanical stress on the cervix by reinforcing it with sutures,
cerclage could also cause scarring of the cervix, which may affect the progress of
labor.
OBJECTIVE
This study aimed to compare the labor curves between individuals who underwent cerclage
and those who did not undergo cerclage.
STUDY DESIGN
This was a retrospective cohort study of individuals with singleton term pregnancy,
vertex presentation, and vaginal delivery, using the data from the Consortium on Safe
Labor. We excluded individuals with fetal anomalies, stillbirth, or abnormal perinatal
outcomes, including 5-minute Apgar score of <7, birth injury, and neonatal intensive
care unit admission. We modeled the course of cervical dilation using repeated-measures
analysis with a polynomial function and generated smoothed labor curves. An interval-censored
regression analysis was performed to estimate traverse times (the elapsed time between
2 cervical dilation measures). The traverse times were compared between individuals
who underwent cerclage and those who did not undergo cerclage, controlling for induction
of labor and parity.
RESULTS
There were 245 individuals who underwent cerclage and 110,080 individuals who did
not undergo cerclage. Individuals who underwent cerclage compared with those who did
not undergo cerclage had a similar traverse time from 1 to 6 cm (median, 9.1 vs 10.3
hours; adjusted P=.37) and from 6 to 10 cm (median, 1.5 vs 1.5 hours; adjusted P=.23). Individuals who underwent cerclage compared with those who did not undergo
cerclage had a longer traverse time from rupture of membranes to delivery (median,
4.0 vs 3.0 hours; adjusted P<.01).
CONCLUSION
Cervical cerclage did not affect the overall progress of labor.
Key words
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Article info
Publication history
Published online: December 30, 2022
Accepted:
December 26,
2022
Received:
December 18,
2022
Footnotes
The authors report no conflict of interest.
Cite this article as: Onishi K, Huang JC, Kawakita T. The effect of cervical cerclage on the labor curve. Am J Obstet Gynecol MFM 2022;XX:x.ex–x.ex.
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