{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T11:24:04Z","timestamp":1775301844860,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In women with a history of one extremely preterm birth, the current literature suggests that ultrasound cervical length screening offers a more favorable risk\u2013benefit ratio than history\u2010indicated cerclage. However, some of the women included in previous studies were at a low risk of cervical insufficiency. Therefore, the efficacy of history\u2010indicated cerclage may have been underestimated. Our objective was to compare history\u2010indicated cerclage with ultrasound cervical length screening in women with a history of one second\u2010trimester loss or extremely preterm birth suggestive of cervical insufficiency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study comparing two centers with different management strategies for women with a history of one second\u2010trimester loss or extremely preterm birth suggestive of cervical insufficiency. This study was conducted from January 1, 2015 to December 31, 2022 in two French tertiary care maternity units. In the first center, women were offered a cerclage in the first trimester (cerclage center). In the second center, women were offered an ultrasound screening with cerclage only for women with cervical shortening (ultrasound center). To target a population at high risk for cervical insufficiency, we included women with a history of one second\u2010trimester loss or spontaneous preterm birth before 28\u2009weeks of gestation. We excluded women who had any of the following complications in their previous pregnancy: bleeding from placenta previa or placental abruption, intrauterine fetal death, or delivery after invasive prenatal testing. We also excluded women with a history of more than one preterm delivery. Our primary outcome was delivery before 34\u2009weeks. A multivariable analysis was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The rate of delivery before 34\u2009weeks was significantly lower in the cerclage center compared with that in the ultrasound center (26\/165 (15.8%) vs. 38\/149 (25.5%),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.032). After adjusting for confounding factors, history\u2010indicated cerclage was associated with a twofold decreased risk of delivery before 34\u2009weeks compared with ultrasound cervical length screening (aOR 0.46, 95% CI 0.23\u20130.95).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In women with a history of one second\u2010trimester loss or extremely preterm birth suggestive of cervical insufficiency, history\u2010indicated cerclage is associated with a lower risk of delivery before 34\u2009weeks compared with ultrasound cervical length screening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.70145","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T03:16:34Z","timestamp":1773026194000},"page":"679-686","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["History\u2010indicated cerclage versus ultrasound cervical length screening in women with a history of one extremely preterm birth: A comparative observational cohort study"],"prefix":"10.1111","volume":"105","author":[{"given":"Mathilde","family":"Terral","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology CHU Toulouse  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chlo\u00e9","family":"Lieng","sequence":"additional","affiliation":[{"name":"Port\u2010Royal Maternity Unit Cochin Hospital, APHP  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Goffinet","sequence":"additional","affiliation":[{"name":"Port\u2010Royal Maternity Unit Cochin Hospital, APHP  Paris France"},{"name":"Centre for Research in Epidemiology and Statistics (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team \u2010 INSERM U1153 Universit\u00e9 de Paris  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2662-4351","authenticated-orcid":false,"given":"Paul","family":"Guerby","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology CHU Toulouse  Toulouse France"},{"name":"Toulouse Institute for Infectious and Inflammatory Diseases Inserm UMR 1291\u2010CNRS UMR 5051, University Toulouse III  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2665-8292","authenticated-orcid":false,"given":"Yoann","family":"Athiel","sequence":"additional","affiliation":[{"name":"Port\u2010Royal Maternity Unit Cochin Hospital, APHP  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0539-3752","authenticated-orcid":false,"given":"Lola","family":"Loussert","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology CHU Toulouse  Toulouse France"},{"name":"Centre for Research in Epidemiology and Statistics (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team \u2010 INSERM U1153 Universit\u00e9 de Paris  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,7]]},"reference":[{"key":"e_1_2_13_2_1","unstructured":"Born too soon: decade of action on preterm birth [Internet]. 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