A randomized controlled trial of cervical scanning vs history to determine cerclage in women at high risk of preterm birth (CIRCLE trial)

被引：42
|
作者：
Simcox, Rachael [1 ]
Seed, Paul T. [1 ]
Bennett, Phillip [2 ]
Teoh, T. G. [3 ]
Poston, Lucilla [1 ]
Shennan, Andrew H. [1 ]
机构：
[1] Kings Coll London, St Thomas Hosp, Maternal & Fetal Res Unit, Div Reprod & Endocrinol, London SE1 7EH, England
[2] Univ London Imperial Coll Sci Technol & Med, Fac Med, Inst Reprod & Dev Biol, London, England
[3] St Marys Hosp, London, England
来源：
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY | 2009年 / 200卷 / 06期
关键词：
cerclage; cervical scanning; preterm birth; BED REST; PREVENTION; DELIVERY; POPULATION; LENGTH;
D O I：
10.1016/j.ajog.2009.03.010
中图分类号：
R71 [妇产科学];
学科分类号：
100211 ;
摘要：
OBJECTIVE: We sought to compare history-indicated placement of cervical cerclage based on history-vs ultrasound-indicated placement in women at risk of preterm birth. STUDY DESIGN: We conducted a randomized controlled trial of history-indicated cervical cerclage suture based on history (clinician preference) vs ultrasound (< 20 mm cervical length) indicated in women at increased risk. RESULTS: The incidence of the primary outcome, preterm delivery between 24(+0) and 33(+6) weeks, was similar: 19/125 (15%) in the history-indicated group vs 18/122 (15%) in the ultrasound- indicated group (relative risk [RR], 0.97; 95% confidence interval [CI], 0.54-1.76). Those women randomized to the ultrasound- indicated arm were significantly more likely to receive a cerclage (32% vs 19%; RR, 1.66; 95% CI, 1.07-2.47) and progesterone (39% vs 25%; RR, 1.55; 95% CI, 1.06-2.25). CONCLUSION: Screening women at high risk with cervical ultrasound to determine cerclage placement results in more intervention but similar outcome compared with history-indicated placement.
引用
收藏
页码：623.e1 / 623.e6
页数：6
相关论文
共 50 条
  • [1] Multicenter randomized trial of cerclage for preterm birth prevention in high-risk women with shortened midtrimester cervical length
    Owen, John
    Hankins, Gary
    Iams, Jay D.
    Berghella, Vincenzo
    Sheffield, Jeanne S.
    Perez-Delboy, Annette
    Egerman, Robert S.
    Wing, Deborah A.
    Tomlinson, Mark
    Silver, Richard
    Ramin, Susan M.
    Guzman, Edwin R.
    Gordon, Michael
    How, Helen Y.
    Knudtson, Eric J.
    Szychowski, Jeff M.
    Cliver, Suzanne
    Hauth, John C.
    AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2009, 201 (04) : 375.e1 - 375.e8
  • [2] Cerclage in singleton pregnancies with no prior spontaneous preterm birth and short cervix: a randomized controlled trial
    Boelig, Rupsa C.
    Tersigni, Chiara
    Di Simone, Nicoletta
    Saccone, Gabriele
    Facchinetti, Fabio
    Scambia, Giovanni
    Berghella, Vincenzo
    AMERICAN JOURNAL OF OBSTETRICS & GYNECOLOGY MFM, 2025, 7 (04)
  • [3] Cerclage Pessary for Preventing Preterm Birth in Women with a Singleton Pregnancy and a Short Cervix at 20 to 24 Weeks: A Randomized Controlled Trial
    Hui, Shuk Yi Annie
    Chor, Chung Ming
    Lau, Tze Kin
    Lao, Terence T.
    Leung, Tak Yeung
    AMERICAN JOURNAL OF PERINATOLOGY, 2013, 30 (04) : 283 - 288
  • [4] A multi-centre, non-inferiority, randomised controlled trial to compare a cervical pessary with a cervical cerclage in the prevention of preterm delivery in women with short cervical length and a history of preterm birth - PC study
    Koullali, Bouchra
    van Kempen, Liselotte E. M.
    van Zijl, Maud D.
    Naaktgeboren, Christiana A.
    Schuit, Ewoud
    Bekedam, Dick J.
    Franssen, Maureen T. M.
    Bijvank, Sebastiaan W. A. Nij
    Sueters, Marieke
    van Baal, Marchien
    de Boer, Marjon A.
    Hooker, Angelo B.
    Hermsen, Brenda B. J.
    Toolenaar, Toon A. A. M.
    Zwart, Joost J.
    van der Ham, David P.
    van der Made, Flip W.
    Prefumo, Federico
    de Tejada, Begona Martinez
    Papatsonis, Dimitri N. M.
    Huisjes, Anjoke J. M.
    Scheepers, Liesbeth H. C. J.
    van Hoorn, Marion E.
    Hasaart, Tom H. M.
    Schuitemaker, Nico W. E.
    Vollebregt, Karlijn C.
    Mueller, Moira A.
    Evers, Inge M.
    Post, Marinka S.
    de Boer, Karin
    Visser, Henricus
    van Charante, Nico A. Mensing
    Langenveld, Josje
    Steemers, Nicole Y. C.
    Mol, Ben W. J.
    Oudijk, Martijn A.
    Pajkrt, Eva
    BMC PREGNANCY AND CHILDBIRTH, 2017, 17
  • [5] Cervical cerclage vs cervical pessary in women with cervical insufficiency: A multicentric, open-label, randomised, controlled pilot trial [the CEPEIC trial]
    Gascon, Andrea
    Maiz, Nerea
    Brik, Maia
    Mendoza, Manel
    del Barco, Ester
    Carreras, Elena
    Goya, Maria
    EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY-X, 2024, 24
  • [6] A multi-centre, non-inferiority, randomised controlled trial to compare a cervical pessary with a cervical cerclage in the prevention of preterm delivery in women with short cervical length and a history of preterm birth – PC study
    Bouchra Koullali
    Liselotte E.M. van Kempen
    Maud D. van Zijl
    Christiana A. Naaktgeboren
    Ewoud Schuit
    Dick J. Bekedam
    Maureen T.M. Franssen
    Sebastiaan W.A. Nij Bijvank
    Marieke Sueters
    Marchien van Baal
    Marjon A. de Boer
    Angelo B. Hooker
    Brenda B.J. Hermsen
    Toon A.A.M. Toolenaar
    Joost J. Zwart
    David P. van der Ham
    Flip W. van der Made
    Federico Prefumo
    Begoña Martinez de Tejada
    Dimitri N.M. Papatsonis
    Anjoke J.M. Huisjes
    Liesbeth H.C.J. Scheepers
    Marion E. van Hoorn
    Tom H.M. Hasaart
    Nico W.E. Schuitemaker
    Karlijn C. Vollebregt
    Moira A. Müller
    Inge M. Evers
    Marinka S. Post
    Karin de Boer
    Henricus Visser
    Nico A. Mensing van Charante
    Josje Langenveld
    Nicole Y.C. Steemers
    Ben W.J. Mol
    Martijn A. Oudijk
    Eva Pajkrt
    BMC Pregnancy and Childbirth, 17
  • [7] Randomized trial of screening for preterm birth in low-risk women - the preterm birth screening study
    Saccone, Gabriele
    Maruotti, Giuseppe Maria
    Morlando, Maddalena
    Visentin, Silvia
    De Angelis, Carlo
    Sarno, Laura
    Cosmi, Erich
    Torcia, Francesco
    Costanzi, Flavia
    Gragnano, Elisabetta
    Bartolini, Giorgia
    La Verde, Marco
    Borelli, Felice
    Savoie, Fabiana
    Schiattarella, Antonio
    De Franciscis, Pasquale
    Locci, Mariavittoria
    Guida, Maurizio
    AMERICAN JOURNAL OF OBSTETRICS & GYNECOLOGY MFM, 2024, 6 (05)
  • [8] Risk scoring in predicting preterm birth of women receiving cervical cerclage
    Fattah, Chro Najmaddin
    BALI MEDICAL JOURNAL, 2020, 9 (03) : 605 - 612
  • [9] Cervical pessary placement for prevention of preterm birth in unselected twin pregnancies: a randomized controlled trial
    Nicolaides, Kypros H.
    Syngelaki, Argyro
    Poon, Liona C.
    de Paco Matallana, Catalina
    Plasencia, Walter
    Molina, Francisca S.
    Picciarelli, Gemma
    Tul, Natasa
    Celik, Ebru
    Lau, Tze Kin
    Conturso, Roberto
    AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2016, 214 (01) : 3.e1 - 3.e9
  • [10] 17 alpha-hydroxyprogesterone caproate does not prolong pregnancy or reduce the rate of preterm birth in women at high risk for preterm delivery and a short cervix: a randomized controlled trial
    Winer, Norbert
    Bretelle, Florence
    Senat, Marie-Victoire
    Bohec, Caroline
    Deruelle, Philippe
    Perrotin, Frank
    Connan, Laure
    Vayssiere, Christophe
    Langer, Bruno
    Capelle, Marianne
    Azimi, Shohreh
    Porcher, Raphael
    Rozenberg, Patrick
    AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2015, 212 (04)
12345