{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T18:33:54Z","timestamp":1774463634358,"version":"3.50.1"},"reference-count":36,"publisher":"Walter de Gruyter GmbH","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,10,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpm-2017-0218_s_999_w2aab3b7c23b1b6b1aab1c16b1Aa\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To compare pregnancy outcomes of physical examination-indicated cerclage in twin pregnancies with acute cervical insufficiency with that of singletons.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2017-0218_s_998_w2aab3b7c23b1b6b1aab1c16b2Aa\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This retrospective cohort study included 88 consecutive women (17 twins and 71 singletons) who had undergone physical examination-indicated cerclage because of acute cervical insufficiency (defined as painless cervical dilation with (1) prolapsed and\/or visible membranes at the external cervical os on speculum examination and (2) a functional cervical length of zero on transvaginal ultrasound) between 16<jats:sup>0\/7<\/jats:sup> and 23<jats:sup>6\/7<\/jats:sup> weeks. The primary outcome measure was preterm delivery &lt;34 weeks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2017-0218_s_997_w2aab3b7c23b1b6b1aab1c16b3Aa\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>(1) The frequency of preterm delivery &lt;34 weeks was not significantly different between the two groups [twins, 56% (9\/16) vs. singleton, 53% (37\/70), P&gt;0.999]. (2) The perinatal mortality was 21% (7\/34) in twins and 32% (23\/71) in singletons. (3) The median gestational age at delivery for twin pregnancies was 31.0 weeks (IQR, 22.6\u201336.5 weeks), which was similar to that of singleton pregnancies (median 32.4 weeks; IQR 22.3\u201338.3 weeks). (4) There were no significant differences in preterm delivery before 28 and 32 weeks, interval from cerclage to delivery within 1, 2, 4 and 8 weeks and neonatal morbidities between the two groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2017-0218_s_996_w2aab3b7c23b1b6b1aab1c16b4Aa\">\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The obstetric and neonatal outcomes of physical examination-indicated cerclage in twin pregnancies were comparable to those in singleton pregnancies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpm-2017-0218","type":"journal-article","created":{"date-parts":[[2017,11,8]],"date-time":"2017-11-08T22:16:26Z","timestamp":1510179386000},"page":"845-852","source":"Crossref","is-referenced-by-count":18,"title":["Outcomes of physical examination-indicated cerclage in twin pregnancies with acute cervical insufficiency compared to singleton pregnancies"],"prefix":"10.1515","volume":"46","author":[{"given":"Jee Yoon","family":"Park","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology , Seoul National University Bundang Hospital , Gyeonggi-do , Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soo-hyun","family":"Cho","sequence":"additional","affiliation":[{"name":"Health Promotion Center , Seoul National University Bundang Hospital , Gyeonggi-do , Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Se Jeong","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Seoul National University Bundang Hospital , Gyeonggi-do , Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Song Yi","family":"Kook","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Seoul National University Bundang Hospital , Gyeonggi-do , Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyunsoo","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Seoul National University Bundang Hospital , Gyeonggi-do , Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyung Joon","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Seoul National University Bundang Hospital , Gyeonggi-do , Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joon-Seok","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Seoul National University Bundang Hospital , Gyeonggi-do , Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2017,11,8]]},"reference":[{"key":"2025021113115665221_j_jpm-2017-0218_ref_001_w2aab3b7c23b1b6b1ab2b2b1Aa","unstructured":"Martin JA, Hamilton BE, Osterman MJ, Driscoll AK, Mathews TJ. Births: final data for 2015. Natl Vital Stat Rep. 2017;66:1."},{"key":"2025021113115665221_j_jpm-2017-0218_ref_002_w2aab3b7c23b1b6b1ab2b2b2Aa","unstructured":"Magee BD. Role of multiple births in very low birth weight and infant mortality. J Reprod Med. 2004;49:812\u20136."},{"key":"2025021113115665221_j_jpm-2017-0218_ref_003_w2aab3b7c23b1b6b1ab2b2b3Aa","doi-asserted-by":"crossref","unstructured":"Goldenberg RL, Iams JD, Miodovnik M, Van Dorsten JP, Thurnau G, Bottoms S, et al. The preterm prediction study: risk factors in twin gestations. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Am J Obstet Gynecol. 1996;175: 1047\u201353.","DOI":"10.1016\/S0002-9378(96)80051-2"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_004_w2aab3b7c23b1b6b1ab2b2b4Aa","doi-asserted-by":"crossref","unstructured":"Miller ES, Rajan PV, Grobman WA. Outcomes after physical examination-indicated cerclage in twin gestations. Am J Obstet Gynecol. 2014;211:46 e1\u20135.","DOI":"10.1016\/j.ajog.2014.03.034"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_005_w2aab3b7c23b1b6b1ab2b2b5Aa","doi-asserted-by":"crossref","unstructured":"Alsulmi E, Schneider C. Cervical insufficiency and cervical cerclage. J Obstet Gynaecol Can. 2014;36:862.","DOI":"10.1016\/S1701-2163(15)30432-1"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_006_w2aab3b7c23b1b6b1ab2b2b6Aa","doi-asserted-by":"crossref","unstructured":"American College of Obstetricians and Gynecologists. ACOG practice bulletin No.142: cerclage for the management of cervical insufficiency. Obstet Gynecol. 2014;123:372\u20139.","DOI":"10.1097\/01.AOG.0000443276.68274.cc"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_007_w2aab3b7c23b1b6b1ab2b2b7Aa","doi-asserted-by":"crossref","unstructured":"Lee SE, Romero R, Park CW, Jun JK, Yoon BH. The frequency and significance of intraamniotic inflammation in patients with cervical insufficiency. Am J Obstet Gynecol. 2008;198:633 e1\u20138.","DOI":"10.1016\/j.ajog.2007.11.047"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_008_w2aab3b7c23b1b6b1ab2b2b8Aa","doi-asserted-by":"crossref","unstructured":"Paules C, Moreno E, Gonzales A, Fabre E, Gonzalez de Aguero R, Oros D. Amniotic fluid sludge as a marker of intra-amniotic infection and histological chorioamnionitis in cervical insufficiency: a report of four cases and literature review. J Matern Fetal Neonatal Med. 2016;29:2681\u20134.","DOI":"10.3109\/14767058.2015.1101445"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_009_w2aab3b7c23b1b6b1ab2b2b9Aa","doi-asserted-by":"crossref","unstructured":"Althuisius SM, Dekker GA, Hummel P, van Geijn HP, Cervical incompetence prevention randomized cerclage trial: emergency cerclage with bed rest versus bed rest alone. Am J Obstet Gynecol. 2003;189:907\u201310.","DOI":"10.1067\/S0002-9378(03)00718-X"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_010_w2aab3b7c23b1b6b1ab2b2c10Aa","doi-asserted-by":"crossref","unstructured":"Daskalakis G, Papantoniou N, Mesogitis S, Antsaklis A. Management of cervical insufficiency and bulging fetal membranes. Obstet Gynecol. 2006;107:221\u20136.","DOI":"10.1097\/01.AOG.0000187896.04535.e6"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_011_w2aab3b7c23b1b6b1ab2b2c11Aa","doi-asserted-by":"crossref","unstructured":"Gupta M, Emary K, Impey L. Emergency cervical cerclage: predictors of success. J Matern Fetal Neonatal Med. 2010;23:670\u20134.","DOI":"10.3109\/14767050903387011"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_012_w2aab3b7c23b1b6b1ab2b2c12Aa","doi-asserted-by":"crossref","unstructured":"Pereira L, Cotter A, Gomez R, Berghella V, Prasertcharoensuk W, Rasanen J, et al. Expectant management compared with physical examination-indicated cerclage (EM-PEC) in selected women with a dilated cervix at 14(0\/7)\u201325(6\/7) weeks: results from the EM-PEC international cohort study. Am J Obstet Gynecol. 2007;197:483 e1\u20138.","DOI":"10.1016\/j.ajog.2007.05.041"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_013_w2aab3b7c23b1b6b1ab2b2c13Aa","doi-asserted-by":"crossref","unstructured":"Stupin JH, David M, Siedentopf JP, Dudenhausen JW. Emergency cerclage versus bed rest for amniotic sac prolapse before 27 gestational weeks. A retrospective, comparative study of 161 women. Eur J Obstet Gynecol Reprod Biol. 2008;139:32\u20137.","DOI":"10.1016\/j.ejogrb.2007.11.009"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_014_w2aab3b7c23b1b6b1ab2b2c14Aa","doi-asserted-by":"crossref","unstructured":"Ventolini G, Genrich TJ, Roth J, Neiger R. Pregnancy outcome after placement of \u2018rescue\u2019 Shirodkar cerclage. J Perinatol. 2009;29:276\u20139.","DOI":"10.1038\/jp.2008.221"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_015_w2aab3b7c23b1b6b1ab2b2c15Aa","doi-asserted-by":"crossref","unstructured":"Meath AJ, Ramsey PS, Mulholland TA, Rosenquist RG, Lesnick T, Ramin KD. Comparative longitudinal study of cervical length and induced shortening changes among singleton, twin, and triplet pregnancies. Am J Obstet Gynecol. 2005;192:1410\u20135.","DOI":"10.1016\/j.ajog.2005.01.033"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_016_w2aab3b7c23b1b6b1ab2b2c16Aa","doi-asserted-by":"crossref","unstructured":"Ramin KD, Ogburn PL, Jr., Mulholland TA, Breckle RJ, Ramsey PS. Ultrasonographic assessment of cervical length in triplet pregnancies. Am J Obstet Gynecol. 1999;180:1442\u20135.","DOI":"10.1016\/S0002-9378(99)70033-5"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_017_w2aab3b7c23b1b6b1ab2b2c17Aa","doi-asserted-by":"crossref","unstructured":"Imseis HM, Albert TA, Iams JD. Identifying twin gestations at low risk for preterm birth with a transvaginal ultrasonographic cervical measurement at 24 to 26 weeks\u2019 gestation. Am J Obstet Gynecol. 1997;177:1149\u201355.","DOI":"10.1016\/S0002-9378(97)70032-2"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_018_w2aab3b7c23b1b6b1ab2b2c18Aa","unstructured":"Kushnir O, Izquierdo LA, Smith JF, Blankstein J, Curet LB. Transvaginal sonographic measurement of cervical length. Evaluation of twin pregnancies. J Reprod Med. 1995;40:380\u20132."},{"key":"2025021113115665221_j_jpm-2017-0218_ref_019_w2aab3b7c23b1b6b1ab2b2c19Aa","doi-asserted-by":"crossref","unstructured":"Althuisius SM, Dekker GA, van Geijn HP, Bekedam DJ, Hummel P. Cervical incompetence prevention randomized cerclage trial (CIPRACT): study design and preliminary results. Am J Obstet Gynecol. 2000;183:823\u20139.","DOI":"10.1067\/mob.2000.108874"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_020_w2aab3b7c23b1b6b1ab2b2c20Aa","doi-asserted-by":"crossref","unstructured":"Eskandar M, Shafiq H, Almushait MA, Sobande A, Bahar AM. Cervical cerclage for prevention of preterm birth in women with twin pregnancy. Int J Gynaecol Obstet. 2007;99:110\u20132.","DOI":"10.1016\/j.ijgo.2007.05.022"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_021_w2aab3b7c23b1b6b1ab2b2c21Aa","doi-asserted-by":"crossref","unstructured":"Ciavattini A, Delli Carpini G, Boscarato V, Febi T, Di Giuseppe J, Landi B. Effectiveness of emergency cerclage in cervical insufficiency. J Matern Fetal Neonatal Med. 2016;29:2088\u201392.","DOI":"10.3109\/14767058.2015.1075202"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_022_w2aab3b7c23b1b6b1ab2b2c22Aa","doi-asserted-by":"crossref","unstructured":"Brown R, Gagnon R, Delisle MF, Maternal Fetal Medicine C. Cervical insufficiency and cervical cerclage. J Obstet Gynaecol Can. 2013;35:1115\u201327.","DOI":"10.1016\/S1701-2163(15)30764-7"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_023_w2aab3b7c23b1b6b1ab2b2c23Aa","doi-asserted-by":"crossref","unstructured":"Rutanen EM. Cerclage in cervical insufficiency: when and to whom? Acta Obstet Gynecol Scand. 2007;86:387\u20138.","DOI":"10.1080\/00016340701239651"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_024_w2aab3b7c23b1b6b1ab2b2c24Aa","unstructured":"Aguilera M, Ramin K, Nguyen R, Giacobbe L, Swartout J. Emergency cerclage placement in multifetal pregnancies with a dilated cervix and exposed membranes: case series. AJP Rep. 2013;3:1\u20134."},{"key":"2025021113115665221_j_jpm-2017-0218_ref_025_w2aab3b7c23b1b6b1ab2b2c25Aa","doi-asserted-by":"crossref","unstructured":"Rebarber A, Bender S, Silverstein M, Saltzman DH, Klauser CK, Fox NS. Outcomes of emergency or physical examination-indicated cerclage in twin pregnancies compared to singleton pregnancies. Eur J Obstet Gynecol Reprod Biol. 2014;173:43\u20137.","DOI":"10.1016\/j.ejogrb.2013.11.016"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_026_w2aab3b7c23b1b6b1ab2b2c26Aa","doi-asserted-by":"crossref","unstructured":"Groom KM, Shennan AH, Bennett PR. Ultrasound-indicated cervical cerclage: outcome depends on preoperative cervical length and presence of visible membranes at time of cerclage. Am J Obstet Gynecol. 2002;187:445\u20139.","DOI":"10.1067\/mob.2002.123937"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_027_w2aab3b7c23b1b6b1ab2b2c27Aa","doi-asserted-by":"crossref","unstructured":"Berghella V, Ciardulli A, Rust OA, To M, Otsuki K, Althuisius S, et al. Cerclage for short cervix on ultrasound in singleton gestations without prior spontaneous preterm birth: a systematic review and meta-analysis of trials using individual patient-level data. Ultrasound Obstet Gynecol. 2017 [Epub ahead of print]. doi: 10.1002\/uog.17457.","DOI":"10.1002\/uog.17457"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_028_w2aab3b7c23b1b6b1ab2b2c28Aa","doi-asserted-by":"crossref","unstructured":"Berghella V, Odibo AO, To MS, Rust OA, Althuisius SM. Cerclage for short cervix on ultrasonography: meta-analysis of trials using individual patient-level data. Obstet Gynecol. 2005;106:181\u20139.","DOI":"10.1097\/01.AOG.0000168435.17200.53"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_029_w2aab3b7c23b1b6b1ab2b2c29Aa","doi-asserted-by":"crossref","unstructured":"Park KH, Kim SN, Oh KJ, Lee SY, Jeong EH, Ryu A. Noninvasive prediction of intra-amniotic infection and\/or inflammation in preterm premature rupture of membranes. Reprod Sci. 2012;19:658\u201365.","DOI":"10.1177\/1933719111432869"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_030_w2aab3b7c23b1b6b1ab2b2c30Aa","doi-asserted-by":"crossref","unstructured":"Roman A, Berghella V. Efficacy of ultrasound-indicated cerclage in twin pregnancies, REPLAY. Am J Obstet Gynecol. 2016;214:132\u20133.","DOI":"10.1016\/j.ajog.2015.08.058"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_031_w2aab3b7c23b1b6b1ab2b2c31Aa","doi-asserted-by":"crossref","unstructured":"Poggi SH, Vyas N, Pezzullo JC, Landy HJ, Ghidini A. Therapeutic cerclage may be more efficacious in women who develop cervical insufficiency after a term delivery. Am J Obstet Gynecol. 2009;200:68 e1\u20133.","DOI":"10.1016\/j.ajog.2008.08.005"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_032_w2aab3b7c23b1b6b1ab2b2c32Aa","doi-asserted-by":"crossref","unstructured":"Fuchs F, Senat MV, Fernandez H, Gervaise A, Frydman R, Bouyer J. Predictive score for early preterm birth in decisions about emergency cervical cerclage in singleton pregnancies. Acta Obstet Gynecol Scand. 2012;91:744\u20139.","DOI":"10.1111\/j.1600-0412.2012.01386.x"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_033_w2aab3b7c23b1b6b1ab2b2c33Aa","doi-asserted-by":"crossref","unstructured":"Gimovsky AC, Suhag A, Roman A, Rochelson BL, Berghella V. Pessary versus cerclage versus expectant management for cervical dilation with visible membranes in the second trimester. J Matern Fetal Neonatal Med. 2016;29:1363\u20136.","DOI":"10.3109\/14767058.2015.1049151"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_034_w2aab3b7c23b1b6b1ab2b2c34Aa","doi-asserted-by":"crossref","unstructured":"Dor J, Shalev J, Mashiach S, Blankstein J, Serr DM. Elective cervical suture of twin pregnancies diagnosed ultrasonically in the first trimester following induced ovulation. Gynecol Obstet Invest. 1982;13:55\u201360.","DOI":"10.1159\/000299484"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_035_w2aab3b7c23b1b6b1ab2b2c35Aa","doi-asserted-by":"crossref","unstructured":"Lazar P, Gueguen S, Dreyfus J, Renaud R, Pontonnier G, Papiernik E. Multicentred controlled trial of cervical cerclage in women at moderate risk of preterm delivery. Br J Obstet Gynaecol. 1984;91:731\u20135.","DOI":"10.1111\/j.1471-0528.1984.tb04841.x"},{"key":"2025021113115665221_j_jpm-2017-0218_ref_036_w2aab3b7c23b1b6b1ab2b2c36Aa","doi-asserted-by":"crossref","unstructured":"Rush RW, Isaacs S, McPherson K, Jones L, Chalmers I, Grant A. A randomized controlled trial of cervical cerclage in women at high risk of spontaneous preterm delivery. Br J Obstet Gynaecol. 1984;91:724\u201330.","DOI":"10.1111\/j.1471-0528.1984.tb04840.x"}],"container-title":["Journal of Perinatal Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.degruyter.com\/view\/j\/jpme.2018.46.issue-8\/jpm-2017-0218\/jpm-2017-0218.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpm-2017-0218\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpm-2017-0218\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T13:13:05Z","timestamp":1739279585000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpm-2017-0218\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,8]]},"references-count":36,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2017,11,8]]},"published-print":{"date-parts":[[2018,10,25]]}},"alternative-id":["10.1515\/jpm-2017-0218"],"URL":"https:\/\/doi.org\/10.1515\/jpm-2017-0218","relation":{},"ISSN":["1619-3997","0300-5577"],"issn-type":[{"value":"1619-3997","type":"electronic"},{"value":"0300-5577","type":"print"}],"subject":[],"published":{"date-parts":[[2017,11,8]]}}}