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
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