{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T01:35:50Z","timestamp":1777772150772,"version":"3.51.4"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:p>\n            Objective\u2003Pregnancy outcomes of individuals receiving cervical cerclage when the cervix is dilated are not well known. We sought to examine preterm birth rates after ultrasound or physical examination-indicated cerclage placement according to the degree of cervical dilation.<\/jats:p><jats:p>\n            Study Design\u2003This was a retrospective cohort study of individuals with singleton pregnancies undergoing ultrasound or physical examination-indicated cerclage before 240\/7 weeks of gestation from 2004 to 2018. Individuals were categorized based on the degree of cervical dilation at the time of cerclage. Our primary outcome was preterm delivery at less than 37 weeks of gestation. Multivariable logistic regression was performed to calculate adjusted odds ratios (aOR) with 95th confidence intervals (95% CI), controlling for predefined covariates.<\/jats:p><jats:p>\n            Results\u2003Of 147 individuals undergoing ultrasound or physical examination-indicated cerclage, 90\/147 (61%) had a closed or 0.5\u2009cm dilated cervix at the time of cerclage placement, 45\/147 (31%) had a cervical dilation of 1 to 2.5\u2009cm, and 12\/147 (8%) had a cervical dilation of 3 to 4\u2009cm at the time of placement. Individuals with a cervical dilation of 1 to 2.5\u2009cm compared with those who had a closed cervix did not have increased odds of preterm delivery (58 vs. 42%; aOR: 1.95; 95% CI: 0.93\u20134.07). However, individuals with a cervical dilation of 3 to 4\u2009cm compared with individuals who had a closed cervix had significantly increased odds of preterm delivery (75 vs. 42%; aOR: 4.33; 95% CI: 1.05\u201317.77).<\/jats:p><jats:p>\n            Conclusion\u2003The rate of preterm birth increases with increasing cervical dilation at the time of cerclage placement. However, individuals who have a cerclage placed when the cervix is 1 to 2.5\u2009cm can achieve an outcome that is not significantly different from those who had a cerclage placed when the cervix is closed.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-2203-3696","type":"journal-article","created":{"date-parts":[[2023,11,4]],"date-time":"2023-11-04T01:18:46Z","timestamp":1699060726000},"page":"684-689","source":"Crossref","is-referenced-by-count":4,"title":["Outcomes of Ultrasound or Physical Examination-Indicated Cerclage according to the Degree of Cervical Dilation"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1800-9893","authenticated-orcid":false,"given":"Alyssa C. Savelli","family":"Binsted","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lea","family":"Nehme","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfred Z.","family":"Abuhamad","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuya","family":"Kawakita","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,12,12]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"103.e1","DOI":"10.1016\/j.ajog.2016.01.004","article-title":"Preterm neonatal morbidity and mortality by gestational age: a contemporary cohort","volume":"215","author":"T A Manuck","year":"2016","journal-title":"Am J Obstet Gynecol"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1002\/uog.15781","article-title":"Cervical length as a predictor for spontaneous preterm birth in high-risk singleton pregnancy: current knowledge","volume":"48","author":"K Hughes","year":"2016","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1097\/AOG.0000000000000850","article-title":"Physical examination\u2013indicated cerclage: a systematic review and meta-analysis","volume":"126","author":"R M Ehsanipoor","year":"2015","journal-title":"Obstet Gynecol"},{"key":"ref5","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":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/01.AOG.0000168435.17200.53","article-title":"Cerclage for short cervix on ultrasonography: meta-analysis of trials using individual patient-level data","volume":"106","author":"V Berghella","year":"2005","journal-title":"Obstet Gynecol"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1097\/GRF.0b013e31804bddfd","article-title":"Contemporary use of cervical cerclage","volume":"50","author":"V Berghella","year":"2007","journal-title":"Clin Obstet Gynecol"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.ajog.2017.11.576","article-title":"Vaginal progesterone for preventing preterm birth and adverse perinatal outcomes in singleton gestations with a short cervix: a meta-analysis of individual patient data","volume":"218","author":"R Romero","year":"2018","journal-title":"Am J Obstet Gynecol"},{"issue":"22","key":"ref9","doi-asserted-by":"crossref","first-page":"2362","DOI":"10.1001\/jama.2013.6295","article-title":"Maternal obesity and risk of preterm delivery","volume":"309","author":"S Cnattingius","year":"2013","journal-title":"JAMA"},{"issue":"43","key":"ref10","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.15585\/mmwr.mm6543a1","article-title":"Effects of maternal age and age-specific preterm birth rates on overall preterm birth rates\u2014United States, 2007 and 2014","volume":"65","author":"C Ferr\u00e9","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"04","key":"ref11","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1067\/S0002-9378(03)00718-X","article-title":"Cervical incompetence prevention randomized cerclage trial: emergency cerclage with bed rest versus bed rest alone","volume":"189","author":"S M Althuisius","year":"2003","journal-title":"Am J Obstet Gynecol"},{"issue":"05","key":"ref12","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1590\/1806-9282.65.5.598","article-title":"Emergency cerclage: gestational and neonatal outcomes","volume":"65","author":"M MF Costa","year":"2019","journal-title":"Rev Assoc Med Bras"},{"issue":"03","key":"ref13","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.ijgo.2013.08.021","article-title":"A review of the contemporary evidence on rescue cervical cerclage","volume":"124","author":"H Abu Hashim","year":"2014","journal-title":"Int J Gynaecol Obstet"},{"issue":"03","key":"ref14","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1055\/s-2007-999307","article-title":"Emergency cerclages: a review of 40 consecutive procedures","volume":"9","author":"A G Mitra","year":"1992","journal-title":"Am J Perinatol"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/S0301-2115(98)00023-2","article-title":"Emergency cervical cerclage: a study between duration of cerclage in situ with gestation at cerclage, herniation of forewater, and cervical dilatation at presentation","volume":"78","author":"S-K Yip","year":"1998","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"04","key":"ref16","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1034\/j.1600-0412.2000.079004265.x","article-title":"Emergency cerclage in the presence of protruding membranes: is pregnancy outcome predictable?","volume":"79","author":"A Caruso","year":"2000","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"07","key":"ref17","doi-asserted-by":"crossref","first-page":"670","DOI":"10.3109\/14767050903387011","article-title":"Emergency cervical cerclage: predictors of success","volume":"23","author":"M Gupta","year":"2010","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"15","key":"ref18","doi-asserted-by":"crossref","first-page":"2527","DOI":"10.1080\/14767058.2018.1554050","article-title":"Cervical length, cervical dilation, and gestational age at cerclage placement and the risk of preterm birth in women undergoing ultrasound or exam indicated Shirodkar cerclage","volume":"33","author":"C A Bigelow","year":"2020","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"02","key":"ref19","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1097\/GRF.0000000000000197","article-title":"Emergency cerclage: outcomes, patient selection, and operative considerations","volume":"59","author":"M Naqvi","year":"2016","journal-title":"Clin Obstet Gynecol"},{"issue":"06","key":"ref20","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.jogoh.2019.01.002","article-title":"Does emergency cerclage really works in patients with advanced cervical dilatation?","volume":"48","author":"I Uzun Cilingir","year":"2019","journal-title":"J Gynecol Obstet Hum Reprod"},{"issue":"06","key":"ref21","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.3390\/jcm10061270","article-title":"Emergency cervical cerclage","volume":"10","author":"M Wierzchowska-Opoka","year":"2021","journal-title":"J Clin Med"},{"issue":"06","key":"ref22","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1111\/j.1600-0412.2012.01386.x","article-title":"Predictive score for early preterm birth in decisions about emergency cervical cerclage in singleton pregnancies","volume":"91","author":"F Fuchs","year":"2012","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"03","key":"ref23","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1002\/ijgo.12144","article-title":"Retrospective comparison of perinatal outcomes following emergency cervical cerclage with or without prolapsed membranes","volume":"137","author":"P Steenhaut","year":"2017","journal-title":"Int J Gynaecol Obstet"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2203-3696.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T10:16:41Z","timestamp":1730801801000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2203-3696"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,3]]},"references-count":22,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2024,4,10]]},"published-print":{"date-parts":[[2024,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2203-3696","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,11,3]]},"published":{"date-parts":[[2023,11,3]]}}}