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Prediction of outcomes for rescue cerclage in cervical insufficiency: A multicenter retrospective study.
Hong, Subeen; Chung, Hyun Sik; Choi, Sujin; Jo, Yun Sung.
Afiliación
  • Hong S; Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 06591 Seoul, Republic of Korea.
  • Chung HS; Department of Anesthesiology and Pain Medicine, Eunpyeong St. Mary's Hospital College of Medicine, The Catholic University of Korea, 06591 Seoul, Republic of Korea.
  • Choi S; Department of Obstetrics and Gynecology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 06591 Seoul, Republic of Korea.
  • Jo YS; Department of Obstetrics and Gynecology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 06591 Seoul, Republic of Korea.
Int J Med Sci ; 21(5): 896-903, 2024.
Article en En | MEDLINE | ID: mdl-38617007
ABSTRACT

Purpose:

Cervical insufficiency is a significant risk factor for preterm birth and miscarriage during the second trimester; cervical cerclage is a treatment option. This study seeks to evaluate the predictive roles of various clinical factors and to develop predictive models for immediate and long-term outcomes after rescue cerclage.

Methods:

We conducted a multicenter retrospective study on patients who underwent rescue cerclage at 14 to 26 weeks of gestation. Data were collected from the Electronic Medical Record systems of participating hospitals. Outcomes were dichotomized into immediate failure (inability to maintain pregnancy for at least 48 hours post-cerclage, gestational latency < 2 days) and long-term success (maintenance of pregnancy until at least 28 weeks of gestation). Clinical factors influencing these outcomes were analyzed.

Results:

The study included 98 patients. Immediate failure correlated with longer prolapsed membrane lengths, elevated C-reactive protein levels at admission, and extended operation time. The successful maintenance of pregnancy until at least 28 weeks was associated with earlier gestational age at diagnosis, negative AmniSure test results, longer lengths of the functional cervix, and smaller cervical dilatation at the time of cerclage. Binary logistic regression models for immediate failure and long-term success exhibited excellent and good predictive abilities, respectively (AUROC = 0.912, 95% CI 0.834-0.989; and AUROC = 0.872, 95% CI 0.788-0.956).

Conclusion:

The developed logistic regression models offer a valuable tool for the prognostic assessment of patients undergoing rescue cerclage, enabling informed clinical decision-making.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cerclaje Cervical Límite: Female / Humans / Pregnancy Idioma: En Revista: Int J Med Sci Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article Pais de publicación: Australia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cerclaje Cervical Límite: Female / Humans / Pregnancy Idioma: En Revista: Int J Med Sci Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article Pais de publicación: Australia