Abstract
This study aimed to assess the value of prophylactic cervical cerclage in prolonging higher-order multiple pregnancies. This retrospective study included all women with higher-order multiple pregnancies beyond 24 gestational weeks treated at the King Abdullah University Hospital in Irbid, Jordan, and King Fahad Medical City in Riyadh, Saudi Arabia, between February 2014 and January 2015. Selected maternal characteristics and obstetric outcomes were compared between women who received prophylactic cervical cerclage and those who did not. A total of 146 women with higher-order multiple pregnancies were included in the study; of these, 94 (64.4%) underwent a prophylactic cervical cerclage insertion procedure and 52 (35.6%) women did not. No significant difference was found between the two groups with regards to maternal age, parity or number of fetuses. However, the mean gestational age at delivery was significantly higher for women without compared to those with prophylactic cervical cerclage (32.9 weeks versus 31.7 weeks) according to both univariate and multivariate analyses (P = 0.013 and 0.046, respectively). Additionally, 40.4% of women without and 14.9% of women with prophylactic cervical cerclage gave birth after 34 gestational weeks (P = 0.003). Overall, prophylactic cervical cerclage was not associated with prolongation of the pregnancy among women with higher-order multiple pregnancies in the current study.
Highlights
This study aimed to assess the value of prophylactic cervical cerclage in prolonging higherorder multiple pregnancies
This retrospective study included all women with higher-order multiple pregnancies beyond 24 gestational weeks treated at the King Abdullah University Hospital in Irbid, Jordan, and King Fahad Medical City in Riyadh, Saudi Arabia, between February 2014 and January 2015
Advances in Knowledge - Preterm birth poses a great risk to the newborns of multiple pregnancies; reliable data are lacking concerning the effectiveness of prophylactic cervical cerclage in prolonging pregnancy
Summary
Abstract: Objectives: This study aimed to assess the value of prophylactic cervical cerclage in prolonging higherorder multiple pregnancies. Results: A total of 146 women with higher-order multiple pregnancies were included in the study; of these, 94 (64.4%) underwent a prophylactic cervical cerclage insertion procedure and 52 (35.6%) women did not. 40.4% of women without and 14.9% of women with prophylactic cervical cerclage gave birth after 34 gestational weeks (P = 0.003). Conclusion: Overall, prophylactic cervical cerclage was not associated with prolongation of the pregnancy among women with higherorder multiple pregnancies in the current study. Advances in Knowledge - Preterm birth poses a great risk to the newborns of multiple pregnancies; reliable data are lacking concerning the effectiveness of prophylactic cervical cerclage in prolonging pregnancy. - This study confirmed that prophylactic cervical cerclage had no positive impact on perinatal outcomes among women with multiple pregnancies treated at institutions in Jordan and Saudi Arabia. Since the early 1980s, there has been an alarming increase of over 400% in the incidence of higher-order multiple pregnancies due to the use of ovarian hyperstimulants by women after the birth of their first baby conceived via in vitro fertilisation.[1,2,3,4,5] This increase has been associated with financial and logistical problems as well as higher perinatal morbidity and mortality rates among women
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