{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:14:05Z","timestamp":1788174845642,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["2023\/00956\u20109"],"award-info":[{"award-number":["2023\/00956\u20109"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate perinatal outcomes in women undergoing cervical cerclage for prevention of preterm birth in Brazilian maternity hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 1364 women with singleton pregnancies who underwent elective or rescue cervical cerclage between December 2003 and November 2025. Permanent cerclages were excluded. Primary outcomes included perinatal results and early (\u22647\u2009days) and late (&gt;7\u2009days) cerclage\u2010related complications. Analyses were stratified by type of cerclage and use of vaginal progesterone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Elective cerclage was performed in 986 women and rescue cerclage in 378. Preterm birth was significantly less frequent in the elective group (35.7% vs 47.6%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Cervical dilatation at the time of procedure influenced outcomes, with a longer latency period between cerclage and delivery when dilatation was &lt;2\u2009cm (21.26\u2009\u00b1\u20094.8 vs 14.71\u2009\u00b1\u20094.9\u2009weeks). Early complications were uncommon (0.9% vs 2.9%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.006), while late complications were more frequent after rescue cerclage (22.5% vs 28.6%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.019), mainly preterm labor and preterm premature rupture of membranes. Adjuvant vaginal progesterone was not associated with a reduction in cerclage\u2010related complications overall. However, in the rescue cerclage group, progesterone use was associated with higher rates of term birth and live birth, and lower rates of miscarriage and stillbirth.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both elective and rescue cerclages performed favorable perinatal outcomes and low rates of early complications. The benefit of adjuvant vaginal micronized progesterone in perinatal outcomes should be considered hypothesis\u2010generating and warrants confirmation in prospective studies. Our findings highlight the importance of early identification of cervical insufficiency and timely intervention to optimize outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.71336","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T10:15:00Z","timestamp":1788171300000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A multicenter analysis of 1364 elective\/rescue cerclages in Brazil: Perinatal outcomes, complications, and the role of vaginal progesterone"],"prefix":"10.1002","author":[{"given":"Isabella C.","family":"Bragheto","sequence":"first","affiliation":[{"name":"Departamento de Tocoginecologia, Faculdade de Ci\u00eancias M\u00e9dicas Universidade Estadual de Campinas (UNICAMP)  Campinas S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela M.","family":"Pereira","sequence":"additional","affiliation":[{"name":"Departamento de Tocoginecologia, Faculdade de Ci\u00eancias M\u00e9dicas Universidade Estadual de Campinas (UNICAMP)  Campinas S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila","family":"Mirandez","sequence":"additional","affiliation":[{"name":"Departamento de Tocoginecologia Faculdade de Medicina de Jundia\u00ed (FMJ)  Jundia\u00ed S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo Luis","family":"Nomura","sequence":"additional","affiliation":[{"name":"Departamento de Tocoginecologia, Faculdade de Ci\u00eancias M\u00e9dicas Universidade Estadual de Campinas (UNICAMP)  Campinas S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elton Carlos","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Departamento de Tocoginecologia, Faculdade de Ci\u00eancias M\u00e9dicas Universidade 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