Comparison of emergency cervical cerclage and expectant treatment in cervical insufficiency in singleton pregnancy: A meta-analysis

被引:8
作者
Wei, Yanfang [1 ]
Wang, Sumei [2 ]
机构
[1] Guangxi Int Zhuang Med Hosp, Dept Obstet, Nanning, Guangxi Zhuang, Peoples R China
[2] Guangxi Med Univ, Affiliated Hosp 1, Dept Obstet, Nanning, Guangxi Zhuang, Peoples R China
来源
PLOS ONE | 2023年 / 18卷 / 02期
关键词
EXAM-INDICATED CERCLAGE; VAGINAL PROGESTERONE; FETAL MEMBRANES; PRETERM BIRTH; SHIRODKAR CERCLAGE; CONTROLLED TRIAL; RESCUE CERCLAGE; AMNIOTIC-FLUID; BED REST; WOMEN;
D O I
10.1371/journal.pone.0278342
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
ObjectiveTo compare the therapeutic effects of emergency cervical cerclage and expectant treatment in preterm birth due to cervical insufficiency in singleton pregnancy. MethodsA combination of subject words and free words was used to search major domestic and foreign databases. According to inclusion and exclusion criteria, 23 studies were included that met the criteria and quality evaluation and data extraction was carried out. The data were analyzed using STATA 15 and the reporting was done in reference to the list of Preferred Reporting Items for Systematic and Meta-Analyses. ResultsEmergency cervical cerclage was superior to expectant treatment for the primary outcome of pregnancy prolongation (WMD = 5.752, 95% CI 5.194-6.311, 22 studies, N = 1435, I-2 = 97.1%, P = 0.000). Cervical cerclage was also superior to expectant treatment for the secondary outcomes of neonatal birth weight (WMD = 1051.542, 95% CI 594.107-1508.977, 9 studies, N = 609, I-2 = 96.4%, P = 0.000), neonatal Apgar 1 ' (WMD = 2.8720, 95% CI: 2.105-3.639, 11 studies, N = 716, I-2 = 99.0%, P = 0.000), number of live births (OR = 6.018, 95% CI 2.882-12.568, 10 studies, N = 724, I-2 = 55.3%, P = 0.000), deliveries after 32 weeks (OR = 8.030, 95% CI 1.38-46.892, 8 studies, N = 381, I-2 = 85.9%, P = 0.021). deliveries after 34 weeks (OR = 15.91, 95% CI 5.92-42.77, 9 studies, N = 560, I-2 = 59.6%, P = 0.000), number of vaginal deliveries (OR = 3.24, 95% CI 1.32-7.90, 8 studies, N = 502, I-2 = 69.4%, P = 0.018), and number of neonatal survivals (OR = 9.300, 95% CI 3.472-24.910, 10 studies, N = 654, I-2 = 80.5%, P = 0.000). No difference between emergency cervical cerclage and expectant treatment was found in patients with chorioamnionitis (OR = 1.85, 95% CI 0.602-4.583, 4 studies, N = 296, I-2 = 16.3%, P = 0.273). ConclusionBefore the 28th week of pregnancy, emergency cervical cerclage can significantly prolong the gestational week and improve the neonatal survival rate, compared to expectant treatment, in women with singleton pregnancies who have a dilated uterine orifice caused by cervical insufficiency.
引用
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页数:19
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