{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:34:09Z","timestamp":1787506449910,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2015,9,9]],"date-time":"2015-09-09T00:00:00Z","timestamp":1441756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The indications of placement of cerclage have recently changed, and so it is important to evaluate how many women are undergoing this procedure. With the recent completion of clinical trials, it is plausible that obstetricians and perinatologists may have become more selective in terms of the best candidates for cerclage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective cohort study of women who underwent cerclage for prevention of preterm birth in the Division of Maternal and Fetal Medicine of Thomas Jefferson University Hospital (Philadelphia,\n                      <jats:styled-content style=\"fixed-case\">USA<\/jats:styled-content>\n                      ) over a 16\u2010year period, from 1998 to 2013. We included women with singleton gestations who had a history\u2010indicated (\n                      <jats:styled-content style=\"fixed-case\">HIC<\/jats:styled-content>\n                      ) or ultrasound\u2010indicated cerclage (\n                      <jats:styled-content style=\"fixed-case\">UIC<\/jats:styled-content>\n                      ). Physical examination\u2010indicated cerclage and transabdominal cerclage were excluded. We planned to compare data before and after 2005.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From 1998 to 2013, there were 33\u00a0353 deliveries, of which 16\u00a0871 occurred from 1998 to 2005 and 16\u00a0482 from 2006 to 2013. Of all deliveries, 328 women (1.0%) received\n                      <jats:styled-content style=\"fixed-case\">HIC<\/jats:styled-content>\n                      or\n                      <jats:styled-content style=\"fixed-case\">UIC<\/jats:styled-content>\n                      , and were therefore included in the analysis. Between 1998\u20132005 and 2006\u20132013 there were significant decreases in the overall rate of cerclage (1.4% to 0.6%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), as well as the rate of\n                      <jats:styled-content style=\"fixed-case\">HIC<\/jats:styled-content>\n                      (0.8% to 0.2%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) and\n                      <jats:styled-content style=\"fixed-case\">UIC<\/jats:styled-content>\n                      (0.6% to 0.3%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      During the last 16\u00a0years, the overall rate of\n                      <jats:styled-content style=\"fixed-case\">HIC<\/jats:styled-content>\n                      and\n                      <jats:styled-content style=\"fixed-case\">UIC<\/jats:styled-content>\n                      cerclage at Thomas Jefferson University Hospital significantly declined from 1.4% to 0.6%; significant decreases were seen for both\n                      <jats:styled-content style=\"fixed-case\">HIC<\/jats:styled-content>\n                      and\n                      <jats:styled-content style=\"fixed-case\">UIC<\/jats:styled-content>\n                      . The reason for the lower rate of cerclages may be the recently published evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.12725","type":"journal-article","created":{"date-parts":[[2015,8,6]],"date-time":"2015-08-06T14:27:55Z","timestamp":1438871275000},"page":"1188-1194","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Trends in cerclage use"],"prefix":"10.1111","volume":"94","author":[{"given":"Anju","family":"Suhag","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Division of Maternal\u2010Fetal Medicine Thomas Jefferson University Hospital Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Saccone","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Sciences and Dentistry School of Medicine University of Naples Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Bisulli","sequence":"additional","affiliation":[{"name":"Department of Medical Surgical Sciences Division of Obstetrics and Prenatal Medicine St Orsola Malpighi Hospital University of Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Seligman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Division of Maternal\u2010Fetal Medicine University of Rochester Medical Center Rochester NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Berghella","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Division of Maternal\u2010Fetal Medicine Thomas Jefferson University Hospital Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,9,9]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"299","article-title":"A new method of operative treatment for habitual abortions in the second trimester of pregnancy","volume":"52","author":"Shirodkar VN","year":"1955","journal-title":"Antiseptic"},{"key":"e_1_2_10_3_1","first-page":"346","article-title":"Suture of the cervix for inevitable miscarriage","volume":"64","author":"Mc Donald IA","year":"1957","journal-title":"J Obstet Gynecol"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31820ca847"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1993.tb15300.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000850"},{"key":"e_1_2_10_7_1","unstructured":"CDC National Vital Statistics Report2012. 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