Abstract
BackgroundThe aim of this study was to determine the effect of cerclage in women who underwent cervical conization.MethodsStudy data were collected from the Korea National Health Insurance Claims Database of the Health Insurance Review and Assessment Service for 2009–2013. Women who had a conization in 2009 and a subsequent first delivery between 2009 and 2013 in Korea were enrolled.ResultsAmong the women who had conization in 2009, 1075 women had their first delivery between 2009 and 2013. A cerclage was placed in 161 of the women who were treated by conization. The rate of preterm birth was higher in the women who were treated with cerclage following a conization compared with those without cerclage (10.56 vs 4.27, p < 0.01, respectively). The multivariate regression analysis revealed that the women who were treated cerclage following a conization had an increased risk of preterm delivery compared with women without cerclage (odds ratio (OR), 2.6, 95% confidence interval (CI), 1.4–4.9).ConclusionOur study showed that cerclage associated with an increased risk of preterm birth and preterm premature rupture of membranes in women who underwent conization. Further studies are required to clarify the mechanism by which cerclage affects the risk of preterm birth.
Highlights
The aim of this study was to determine the effect of cerclage in women who underwent cervical conization
The rate of preterm birth was higher in women who underwent cerclage following a conization compared with women without cerclage (10.56 vs 4.27, p < 0.01, respectively)
The multivariate regression analysis (Table 2) revealed that women with cerclage following a conization had an increased risk of preterm delivery compared with women without cerclage
Summary
The aim of this study was to determine the effect of cerclage in women who underwent cervical conization. Preterm birth is defined as delivery before 37 weeks, and it has been implicated in approximately two thirds of infant deaths [1,2,3]. The infant mortality rate has declined over the past century, it has remained a major health problem. Screening for the risk of preterm labor is not beneficial in the general population. A short cervix is one of the poorest predictors of preterm birth [4, 5]. Cervical incompetence is a clinical diagnosis characterized by recurrent, painless cervical dilatation and shortening. Since the 1950s, a cervical cerclage has been a relatively common procedure performed for the treatment of cervical incompetence [6]
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