잠시만 기다려 주세요. 로딩중입니다.

Effect of Cervical Cerclage on the Risk of Recurrent Preterm Birth after a Twin Spontaneous Preterm Birth

Journal of Korean Medical Science 2020년 35권 11호 p.66 ~ 66
김신영, 박현수, 권하얀, 설현주, 배진곤, 안기훈, 나성훈, 이세진, 이미영, 이승미, 곽동욱, Park Jung-Yoon, 박인양, 원혜성, 김문영, 고현선, 황한성,
소속 상세정보
김신영 ( Kim Shin-Young ) - Catholic University College of Medicine Department of Obstetrics and Gynecology
박현수 ( Park Hyun-Soo ) - Dongguk University Ilsan Hospital Department of Obstetrics and Gynecology
권하얀 ( Kwon Ha-Yan ) - Dongguk University Ilsan Hospital Department of Obstetrics and Gynecology
설현주 ( Seol Hyun-Joo ) - Kyung Hee University School of Medicine Kyung Hee University Hospital at Gangdong Department of Obstetrics and Gynecology
배진곤 ( Bae Jin-Gon ) - Keimyung University School of Medicine Keimyung University Dongsan Medical Center Department of Obstetrics and Gynecology
안기훈 ( Ahn Ki-Hoon ) - Korea University Anam Hospital Department of Obstetrics and Gynecology
나성훈 ( Na Sung-Hun ) - Kangwon National University School of Medicine Kangwon National University Hospital Department of Obstetrics and Gynecology
이세진 ( Lee Se-Jin ) - Kangwon National University School of Medicine Kangwon National University Hospital Department of Obstetrics and Gynecology
이미영 ( Lee Mi-Young ) - University of Ulsan College of Medicine Asan Medical Center Department of Obstetrics and Gynecology
이승미 ( Lee Seung-Mi ) - Seoul National University College of Medicine Department of Obstetrics and Gynecology
곽동욱 ( Kwak Dong-Wook ) - Ajou University School of Medicine Department of Obstetrics and Gynecology
 ( Park Jung-Yoon ) - Catholic University College of Medicine Department of Obstetrics and Gynecology
박인양 ( Park In-Yang ) - Catholic University College of Medicine Department of Obstetrics and Gynecology
원혜성 ( Won Hye-Sung ) - University of Ulsan College of Medicine Asan Medical Center Department of Obstetrics and Gynecology
김문영 ( Kim Moon-Young ) - CHA University CHA Gangnam Medical Center Department of Obstetrics and Gynecology
고현선 ( Ko Hyun-Sun ) - Catholic University College of Medicine Department of Obstetrics and Gynecology
황한성 ( Hwang Han-Sung ) - Konkuk University School of Medicine Department of Obstetrics and Gynecology

Abstract


Background: This study aimed to evaluate the effect of cervical cerclage on the recurrence risk for preterm birth in singleton pregnant women after a twin spontaneous preterm birth (sPTB).

Methods: This multicenter retrospective cohort study included women who had a singleton pregnancy from January 2009 to December 2018 at 10 referral hospitals and a twin sPTB before the current pregnancy. We compared the cervical lengths during pregnancy and pregnancy outcomes, according to the placement of prophylactic or emergency cerclage. We evaluated the independent risk factors for sPTB (< 37 weeks of gestation) in a subsequent singleton pregnancy.

Results: For the index singleton pregnancy, preterm birth occurred in seven (11.1%) of 63 women. There was no significant difference in the cervical lengths during pregnancy in women with and without cerclage. In a multivariate logistic regression analysis, the placement of emergency cerclage was an independent risk factor for subsequent singleton preterm birth (odds ratio [OR], 93.188; 95% confidence interval [CI], 1.633?5,316.628; P = 0.027); however, the placement of prophylactic cerclage (OR, 19.264; 95% CI, 0.915?405.786; P = 0.057) was not a factor. None of the women who received prophylactic cerclage delivered before 35 weeks' gestation in the index singleton pregnancy.

Conclusion: Cerclage did not lower the risk of preterm birth in a subsequent singleton pregnancy after a twin sPTB. However, emergency cerclage was an independent risk factor for preterm birth and there was no preterm birth before 35 weeks' gestation in the prophylactic cerclage group. Therefore, close monitoring of the cervical length and prophylactic cerclage might be considered in women who have experienced a twin sPTB at extreme gestation.

키워드

Twins; Premature Birth; Preterm Premature Rupture of the Membranes; Uterine Cervical Incompetence; Cervical Cerclage

원문 및 링크아웃 정보

  

등재저널 정보