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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 2

(635) Amniocentesis prior to physical exam-indicated cerclage placement and time to delivery

Thursday, January 30, 2025
4:00 PM – 6:00 PM  
Objective: To assess the association between amniocentesis prior to physical exam-indicated cerclage and latency from presentation to delivery.

Study Design: This is a single center retrospective cohort study of pregnant individuals who presented for a physical exam-indicated cerclage at 16w0d-23w6d gestation from June 2012 through June 2023. The primary exposure was amniocentesis for evaluation of infection prior to attempted cerclage. The primary outcome was the latency from presentation for possible cerclage placement to delivery. Secondary outcomes were a neonatal morbidity composite, delivery < 28 weeks, delivery < 37 weeks, chorioamnionitis or endometritis, and postpartum hemorrhage. Latency from presentation to delivery was assessed by amniocentesis status using Kaplan-Meier curves and the log-rank test. Modified Poisson regression was used to estimate the relative risk for secondary outcomes, adjusting for confounding factors. A sensitivity analysis was performed, including only individuals with successful cerclage placement.

Results: Of the 78 individuals included who presented for exam-indicated cerclage, 35 (44.9%) underwent amniocentesis. Those who underwent amniocentesis were more likely to have mild symptoms at presentation (54.3% vs 18.6%, p< 0.05), but had similar cervical length, dilation, gestational age at presentation, and history of preterm birth.  Among those in the amniocentesis group, 12 (34.3%) did not receive a cerclage compared to 3 (7%) who did not receive a cerclage in the no amniocentesis group. There was no significant difference in latency from presentation to delivery between those who underwent amniocentesis and those who did not (Figure 1). In adjusted analysis, there were no significant difference in secondary outcomes between groups (Table 1). The results were similar when limited to those with successful cerclage placement (Figure 1).

Conclusion: We found no association between amniocentesis prior to cerclage and latency from presentation to delivery. Given our modest sample size, these findings await confirmation in a larger study.