The impact of obesity on cervical cerclage efficacy: A systematic review of the literature.

Abstract

Cervical cerclage is a commonly applied procedure which is used as a preventive measure against preterm births among women with a short cervix (<25mm) or with previous painless mid-trimester pregnancy losses. The purpose of the present study is to evaluate whether the presence of maternal obesity reduces the efficacy of cervical cerclage. We searched Medline (1966-2015), Scopus (2004-2015), Popline (1974-2015) and ClinicalTrials.gov (2008-2015) along with reference lists of electronically retrieved studies. Three studies were included in our review which involved 606 women. Among them 210 were obese (BMI>30 kg/m2) and 47 morbidly obese (BMI >40 kg/m2). The presence of obesity among women who had a cervical cerclage due to ultrasound or history indications did not seem to affect the gestational age at delivery or the neonatal birthweight. Furthermore, according to the findings of a single study it did not seem to reduce the gestational latency period in days (normal weight group 24.3±3.2, overweight group 21.1±5.1, obese group 21.4±4.9 p = 0.171). According to the findings of our systematic review obesity does not influence the efficacy of cervical cerclage. However, firm results are precluded due to the small number and the methodological heterogeneity of existing studies. Further, studies are needed to corroborate our findings.