Cerclage may not improve outcome in low-risk women

Pregnant women who are at low risk of premature delivery and have a cervical length of 25 mm or less early in the second trimester aren't likely to have a better outcome with cerclage placement, according to a report in the September issue of the American Journal of Obstetrics & Gynecology.

The procedure was not associated with a lower rate of preterm labor or preterm premature rupture of membranes (16.1% with cerclage vs. 11.1% without). Nor was cerclage associated with longer gestational age at delivery (37.6 weeks vs. 38.5 weeks).

"Obstetric history of preterm delivery increases the likelihood that cervical shortening may be the manifestation of cervical incompetence, and thus such history identifies candidates who may benefit from cerclage," the authors write. "In the absence of such history, the obstetrician faces an obstetrical dilemma, with sonographic evidence of increased risk for preterm delivery, yet no interventions available which have been documented to improve the outcome."