(340) Mid-trimester Cervical Length in Patients with a History-Indicated Cerclage and the Risk of Preterm Delivery

To investigate the predictive value of cervical length (CL) in patients with a history-indicated cerclage on preterm delivery (PTB) < 37 weeks.

Study Design:

This was a retrospective cohort study of individuals who had history-indicated cerclage during pregnancy and who delivered at a tertiary referral center between 2014 and 2022. Individuals who did not have cervical length measurement post-cerclage were excluded. Post-cerclage CL was categorized into < 2.5 cm and ≥ 2.5 cm. The primary outcome was preterm birth (PTB) < 37 weeks. Secondary outcomes included PTB < 34 weeks, mode of delivery, chorioamnionitis, postpartum hemorrhage, transfusion, and endometritis. Categorical variables were compared using Chi-squared or Fisher's exact test. Continuous variables were tested for normality using the Shapiro-Wilk test and compared using Student's t-test or Mann-Whitney-U test as applicable.

Results:

A total of 65 patients were included in the study, with 50 having a post-cerclage CL < 2.5 cm and 15 having a post-cerclage CL ≥ 2.5 cm. There was no significant difference in the rates of PTB < 37 weeks between the two groups (32%vs. 46.7%, p=0.36). Similarly, there were no significant difference in the rates of PTB < 34 weeks (p=0.08), mode of delivery (p=1.00), postpartum hemorrhage (p=0.71), transfusion (p=1.00), or endometritis (p=0.23). Significant differences were noted in rates of chorioamnionitis (94.00% for CL < 2.5 cm vs. 73.33% for CL ≥2.5 cm, p=0.04) (Table 1).

Conclusion:

Post-cerclage CL appears to have limited predictive value for PTB and other pregnancy outcomes in the setting of history indicated cerclage. Further research with larger sample sizes is needed to confirm these findings and explore potential clinical implications.