Does cerclage prevent pregnancy loss? The debate continues

February 21, 2008

Using a cervical stitch to prevent singleton pregnancy loss may or may not work. In a recent British meta-analysis, which included seven trials and just over 2,000 women, although the results suggested that cerclage might reduce the risk of pregnancy loss or death of the baby before hospital discharge by 19%, the percentage failed to reach statistical significance (OR 0.81; 95% CI, 0.60-1.10). And efficacy seemed uninfluenced by indication, maternal obstetric history, cervical length, or timing of the procedure during pregnancy.

Using a cervical stitch to prevent singleton pregnancy loss may or may not work. In a recent British meta-analysis, which included seven trials and just over 2,000 women, although the results suggested that cerclage might reduce the risk of pregnancy loss or death of the baby before hospital discharge by 19%, the percentage failed to reach statistical significance (OR 0.81; 95% CI, 0.60-1.10). And efficacy seemed uninfluenced by indication, maternal obstetric history, cervical length, or timing of the procedure during pregnancy.

The analysis also showed that the procedure should not be used for pregnancies with multiple gestations. In this group, according to the data, cerclage has a detrimental effect on the outcome of pregnancy loss or death before discharge from the hospital (OR 5.88; 95% CI, 1.14-30.19), but only a small number of multiple pregnancies were included in the analysis.

Jorgensen AL, Alfirevic Z, Tudor Smith CT, et al. Cervical stitch for preventing pregnancy loss: individual patient data meta-analysis. BJOG. 2007;114:1460-1476.