{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:16:29Z","timestamp":1790345789927,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100013342","name":"NIHR Imperial Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013342","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000912","name":"March of Dimes Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000912","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Cervical cerclage is an important treatment used to prevent spontaneous preterm birth (sPTB), but it is not universally successful. Understanding the factors associated with cerclage treatment failure may lead to improved patient selection and better patient outcomes. The objective of this study was to investigate the value of pre\u2010 and post\u2010cerclage cervical length (CL) in predicting sPTB &lt;\u200934\u2009weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective cohort study conducted in four preterm birth prevention clinics in the UK. We included 331 women who had undergone cervical cerclage between January 2008 and March 2021, and analyzed their pre\u2010 and post\u2010cerclage CL, as measured by transvaginal ultrasound scan. The primary outcome was sPTB &lt;\u200934\u2009weeks' gestation, assessed using multivariable logistic regression modeling (variables were pre\u2010 and post\u2010cerclage CL, gestational age at cerclage and direction of CL change) and the generation of receiver\u2010operating\u2010characteristic (ROC) curves. Differences in sPTB for underlying risk factors (race, smoking history, previous cervical surgery or pregnancy history risk factors, including mid\u2010trimester loss or sPTB) were assessed using Fisher's exact test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both pre\u2010 and post\u2010cerclage CL were independently discriminative of sPTB &lt;\u200934\u2009weeks' gestation, with areas under the ROC curve of 0.635 (95%\u2009CI, 0.559\u20130.712) and 0.677 (95%\u2009CI, 0.604\u20130.751), respectively, and were modest contributors to sPTB prediction based on multivariable logistic regression modeling (odds ratio (OR), 0.964 (95%\u2009CI, 0.936\u20130.994),\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.018 and 0.940 (95%\u2009CI, 0.910\u20130.970),\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001, respectively). There were no significant differences in the rate of sPTB &lt;\u200934\u2009weeks' gestation according to race, smoking history, previous cervical surgery or pregnancy history risk factors, including previous mid\u2010trimester loss or sPTB.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Post\u2010cerclage CL is the predominant predictor of sPTB &lt;\u200934\u2009weeks' gestation. Underlying sPTB risk factors (previous cervical surgery and pregnancy history) may influence pre\u2010cerclage CL and the direction of CL change following cerclage, but once these are adjusted for, they do not influence the risk of sPTB &lt;\u200934\u2009weeks' gestation. \u00a9 2025 The Author(s).\n                      <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic>\n                      published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.29281","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T13:20:04Z","timestamp":1752067204000},"page":"210-216","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Predictive value of cervical length for spontaneous preterm birth in women with cervical cerclage"],"prefix":"10.1002","volume":"66","author":[{"given":"K. E.","family":"Mountain","sequence":"first","affiliation":[{"name":"March of Dimes Prematurity Research Centre at The Institute of Reproductive and Developmental Biology, Department of Metabolism Digestion and Reproduction, Imperial College London  London UK"},{"name":"The Parasol Foundation Centre for Women's Health and Cancer Research Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Ng","sequence":"additional","affiliation":[{"name":"March of Dimes Prematurity Research Centre at The Institute of Reproductive and Developmental Biology, Department of Metabolism Digestion and Reproduction, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6503-5840","authenticated-orcid":false,"given":"T.","family":"Elger","sequence":"additional","affiliation":[{"name":"King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Judah","sequence":"additional","affiliation":[{"name":"King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7265-5442","authenticated-orcid":false,"given":"R.","family":"Akolekar","sequence":"additional","affiliation":[{"name":"Medway NHS Foundation Trust  Gillingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. V.","family":"Lewis","sequence":"additional","affiliation":[{"name":"March of Dimes Prematurity Research Centre at The Institute of Reproductive and Developmental Biology, Department of Metabolism Digestion and Reproduction, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. A.","family":"MacIntyre","sequence":"additional","affiliation":[{"name":"March of Dimes Prematurity Research Centre at The Institute of Reproductive and Developmental Biology, Department of Metabolism Digestion and Reproduction, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Terzidou","sequence":"additional","affiliation":[{"name":"March of Dimes Prematurity Research Centre at The Institute of Reproductive and Developmental Biology, Department of Metabolism Digestion and Reproduction, Imperial College London  London UK"},{"name":"Chelsea and Westminster NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. R.","family":"Bennett","sequence":"additional","affiliation":[{"name":"March of Dimes Prematurity Research Centre at The Institute of Reproductive and Developmental Biology, Department of Metabolism Digestion and Reproduction, Imperial College London  London UK"},{"name":"Queen Charlotte's and Chelsea Hospital Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. G.","family":"Teoh","sequence":"additional","affiliation":[{"name":"March of Dimes Prematurity Research Centre at The Institute of Reproductive and Developmental Biology, Department of Metabolism Digestion and Reproduction, Imperial College London  London UK"},{"name":"St Mary's Hospital, Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7806-5707","authenticated-orcid":false,"given":"L.","family":"Sykes","sequence":"additional","affiliation":[{"name":"March of Dimes Prematurity Research Centre at The Institute of Reproductive and Developmental Biology, Department of Metabolism Digestion and Reproduction, Imperial College London  London UK"},{"name":"The Parasol Foundation Centre for Women's Health and Cancer Research Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1266-0711","authenticated-orcid":false,"given":"K. H.","family":"Nicolaides","sequence":"additional","affiliation":[{"name":"King's College Hospital NHS Foundation Trust  London UK"},{"name":"Harris Birthright Research Centre for Fetal Medicine, King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Born too soon: the global action report on preterm birth","author":"March of Dimes, PMNCH, Save the Children, WHO","year":"2012"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60074-4"},{"issue":"6","key":"e_1_2_7_4_1","article-title":"Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy","volume":"6","author":"Alfirevic Z","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17003"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16351-4"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15600"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2018.08.006"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.03.028"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15566"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1933719108329095"},{"issue":"1","key":"e_1_2_7_12_1","article-title":"Cervical assessment by ultrasound for preventing preterm delivery","volume":"2013","author":"Berghella V","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199602293340904"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(98)00120-3"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0178072"},{"issue":"2","key":"e_1_2_7_16_1","article-title":"Cerclage location and gestational age at delivery","volume":"9","author":"Estrada F","year":"2019","journal-title":"AJP Rep"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.03.033"},{"issue":"25","key":"e_1_2_7_18_1","first-page":"1","article-title":"The association between sonographic cervical length components and preterm birth in women with ultrasound\u2010 or exam\u2010indicated cerclage","volume":"35","author":"Muniz Rodriguez A","year":"2021","journal-title":"J Matern Fetal Neonatal Med"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.5468\/ogs.2016.59.1.17"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12361"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2015.1085963"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i3633"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-022-28620-1"},{"key":"e_1_2_7_24_1","unstructured":"CLEAR: Comprehensive Learning and Evaluation for Advancing Results. 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