Poster Session 2
Sarah H. Abelman, MD (she/her/hers)
Maternal Fetal Medicine Fellow
Northwell
New Hyde Park, New York, United States
Frank I. Jackson, DO (he/him/his)
Maternal Fetal Medicine Fellow
Northwell
New Hyde Park, New York, United States
Nathan A. Keller, MD
Maternal Fetal Medicine Fellow
Northwell
Bay Shore, NY, United States
Julie Chen, BA
Northwell
New Hyde Park, New York, United States
Luis A. Bracero, MD
Maternal Fetal Medicine Physician
Northwell
New Hyde Park, New York, United States
Cara S. Wetcher, MD
MFM Fellow
Northwell
New Hyde Park, New York, United States
Matthew J. Blitz, MD
Director of Clinical Research, Maternal-Fetal Medicine, Northwell; Program Director, Maternal Fetal Medicine Fellowship, South Shore University Hospital
Northwell
Bay Shore, NY, United States
Patients with a very short cervical length < 1cm may benefit from cerclage placement, even in the absence of prior preterm birth. As with exam-indicated cerclages, it is often assumed that rapid cerclage placement improves the benefit of the intervention. This study aimed to determine whether length of time from diagnosis of cervical length < 1cm to cerclage placement affects delivery timing.
Study Design:
This was a retrospective cohort study of all patients who received an ultrasound-indicated cerclage due to a transvaginal cervical length measurement of < 1cm during pregnancy, between January 2018 and December 2023, within a large health system in New York. Patients were excluded if they had a history of prior preterm birth. Patients were categorized based on time elapsed between this diagnosis and cerclage placement. The primary outcome evaluated was gestational age at delivery. Outcomes were compared using a linear mixed model regression analysis and were then adjusted for obesity and gestational age at diagnosis of short cervix.
Results:
99 patients were included who had an ultrasound-indicated cerclage placed for a diagnosis of a cervical length < 1cm, with no prior history of preterm birth. The mean wait time for cerclage placement after diagnosis was 2.3 days. 58 (59%) patients received a cerclage the next day, and 41 (41%) waited 2 or more days. The mean cervical length at diagnosis was 5.8mm ± 2.7 mm in the next-day placement group and was 6.9 mm ± 1.7 mm in the later placement group. The mean gestational age at diagnosis of a short cervix was 20.8 ± 1.8 weeks in the next-day placement group and was 20.1 ± 1.7 weeks in the later placement group. The mean gestational age at delivery in the next-day placement group was 35.4 ± 4.1 weeks, and in the later placement group was 34.7 ± 5.8 weeks, with no significant difference detected between the groups (P=0.51).
Conclusion:
For patients receiving an ultrasound-indicated cerclage for a short cervix < 1cm, there was no benefit to rapid next-day cerclage placement compared to longer wait times of 2 or more days.
