{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:53:16Z","timestamp":1791269596445,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007194","name":"Wenzhou Municipal Science and Technology Bureau","doi-asserted-by":"publisher","award":["Y20240588"],"award-info":[{"award-number":["Y20240588"]}],"id":[{"id":"10.13039\/501100007194","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>Background<\/jats:title>\n                    <jats:p>Cervical cerclage is the most effective intervention for preventing preterm birth (PTB) caused by cervical insufficiency. However, its benefits remain controversial. This study aimed to develop and validate nomogram models to predict cerclage efficiency, defined as the prevention of PTB or extremely preterm birth (EPTB) and the prolongation of gestational latency, in singleton pregnancies with different cerclage indications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective observational study was conducted using data from women who underwent cerclage at our institution, Wenzhou, China, between 2013 and 2023. The eligible participants were categorized into three groups based on the indications for cerclage: a history\u2010indication group (\n                      <jats:italic>n\u2009=<\/jats:italic>\n                      \u2009145), an ultrasound\u2010indication group (\n                      <jats:italic>n\u2009=<\/jats:italic>\n                      \u2009101), and an emergency group (\n                      <jats:italic>n\u2009=<\/jats:italic>\n                      \u200941). PTB (&lt;37\u2009weeks) was the primary outcome for the history\u2010 and ultrasound\u2010indicated groups, while EPTB (&lt;28\u2009weeks) was the primary outcome for the emergency group, with gestational latency as a secondary outcome. Predictors were identified using univariate analysis, followed by binary logistic or Cox regression. Model performance was evaluated by discrimination, calibration, and decision curve analysis. Internal validation was performed using bootstrap resampling (500 repetitions).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For history\u2010indicated cerclage, the nomogram incorporated body mass index at cerclage, preoperative C\u2010reactive protein, and prior cesarean deliveries to predict PTB. For ultrasound\u2010indicated cerclage, PTB predictors were body mass index, miscarriage history, cervical dilation, and operation time. For emergency cerclage, the model for EPTB included vaginal bleeding, U\u2010shaped cervical funneling, and postoperative combination tocolysis. A separate model for gestational latency in the emergency group incorporated U\u2010shaped cervical funneling, cervical dilation, and postoperative ritodrine use. The models demonstrated good discrimination, with apparent areas under the curve (AUCs) of 0.77, 0.75, and 0.92 for predicting PTB\/EPTB in the three groups, respectively. Calibration curves indicated favorable concordance between predicted and observed event probabilities. Bootstrap internal validation demonstrated acceptable internal consistency, with bias\u2010corrected mean AUCs of 0.767, 0.728, and 0.914.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These novel models preliminarily provide accessible and reliable predictions for PTB in women with history or ultrasound indicated cerclage, as well as for EPTB and prolonged gestational latency in women with emergency cerclage. The models have exhibited good predictive values and might assist clinicians in counseling and facilitating personalized management decisions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.71368","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:37:32Z","timestamp":1791268652000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nomogram models for predicting cerclage efficiency in women with different cerclage indications: A 10\u2010year retrospective observational study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4486-2123","authenticated-orcid":false,"given":"Peipei","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology The Second Affiliated Hospital of Wenzhou Medical University  Wenzhou 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Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5991-7214","authenticated-orcid":false,"given":"Haishi","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Second Affiliated Hospital of Wenzhou Medical University  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"issue":"2","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1097\/01.AOG.0000443276.68274.cc","article-title":"ACOG practice bulletin No.142: cerclage for the management of cervical insufficiency","volume":"123","year":"2014","journal-title":"Obstet Gynecol"},{"issue":"2","key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.jogc.2018.08.009","article-title":"No. 373\u2010cervical insufficiency and cervical cerclage","volume":"41","author":"Brown 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