{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T16:12:15Z","timestamp":1778602335955,"version":"3.51.4"},"reference-count":23,"publisher":"Walter de Gruyter GmbH","issue":"2","license":[{"start":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:00:00Z","timestamp":1760918400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpm-2025-0137_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Transvaginal cervical cerclage is a common intervention to prevent preterm birth in high-risk patients. This study aimed to compare McDonald and Shirodkar cerclage techniques in preventing preterm birth among patients with obesity, a group at increased risk for adverse pregnancy outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0137_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was a retrospective study of singleton pregnancies complicated by pre-pregnancy obesity (BMI\u226530\u202fkg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) and transvaginal cerclage placement between 2018 and 2023 within a large health system in New York. The primary exposure was type of cerclage, McDonald or Shirodkar. Primary outcomes were preterm birth &lt;37\u00a0weeks and &lt;34\u00a0weeks. Secondary outcomes were spontaneous preterm birth &lt;37 and &lt;34\u00a0weeks, and gestational age at delivery. Subgroup analyses were performed by cerclage indication (history-, ultrasound-, or exam-indicated). Multivariate logistic regression and linear mixed model analyses were utilized to evaluate these outcomes while controlling for potential confounders.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0137_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 495 patients included, 375 (76\u202f%) underwent McDonald and 120 (24\u202f%) underwent Shirodkar cerclage. In adjusted and unadjusted analyses, there was no significant difference in preterm birth at &lt;37 or &lt;34\u00a0weeks (p=0.98 and p=0.30 respectively) or spontaneous preterm birth at &lt;37 or &lt;34\u00a0weeks (p=0.75 and p=0.36) between the groups. There was no significant difference in mean gestational age at delivery (36.4\u00a0\u00b1\u00a04.3 vs. 35.9\u00a0\u00b1\u00a04.7\u00a0weeks, p=0.50). Subgroup analyses confirmed similar findings across cerclage indications, though with a benefit for the McDonald technique for ultrasound-indicated cerclages (36.6\u00a0\u00b1\u00a04.2 vs. 35.0\u00a0\u00b1\u00a05.1\u00a0weeks, p=0.02).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0137_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>McDonald and Shirodkar cerclages are equally effective in prolonging pregnancy in patients with obesity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpm-2025-0137","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T13:55:46Z","timestamp":1760709346000},"page":"302-308","source":"Crossref","is-referenced-by-count":0,"title":["McDonald vs. Shirodkar cerclage for the prevention of preterm birth in patients with obesity"],"prefix":"10.1515","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0489-6620","authenticated-orcid":false,"given":"Sarah H.","family":"Abelman","sequence":"first","affiliation":[{"name":"Northwell , New Hyde Park , NY , USA"},{"name":"Department of Obstetrics and Gynecology , South Shore University Hospital , Bay Shore , NY , USA"},{"name":"Zucker School of Medicine at Hofstra\/Northwell , Hempstead , NY , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2813-7693","authenticated-orcid":false,"given":"Frank I.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Northwell , New Hyde Park , NY , USA"},{"name":"Department of Obstetrics and Gynecology , South Shore University Hospital , Bay Shore , NY , USA"},{"name":"Zucker School of Medicine at Hofstra\/Northwell , Hempstead , NY , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4066-8489","authenticated-orcid":false,"given":"Nathan A.","family":"Keller","sequence":"additional","affiliation":[{"name":"Northwell , New Hyde Park , NY , USA"},{"name":"Department of Obstetrics and Gynecology , South Shore University Hospital , Bay Shore , NY , USA"},{"name":"Zucker School of Medicine at Hofstra\/Northwell , Hempstead , NY , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Chen","sequence":"additional","affiliation":[{"name":"Northwell , New Hyde Park , NY , USA"},{"name":"Zucker School of Medicine at Hofstra\/Northwell , Hempstead , NY , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis A.","family":"Bracero","sequence":"additional","affiliation":[{"name":"Northwell , New Hyde Park , NY , USA"},{"name":"Department of Obstetrics and Gynecology , South Shore University Hospital , Bay Shore , NY , USA"},{"name":"Zucker School of Medicine at Hofstra\/Northwell , Hempstead , NY , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5534-6928","authenticated-orcid":false,"given":"Matthew J.","family":"Blitz","sequence":"additional","affiliation":[{"name":"Northwell , New Hyde Park , NY , USA"},{"name":"Department of Obstetrics and Gynecology , South Shore University Hospital , Bay Shore , NY , USA"},{"name":"Zucker School of Medicine at Hofstra\/Northwell , Hempstead , NY , USA"},{"name":"Institute of Health Systems Science, Feinstein Institutes for Medical Research , 5799 Northwell Health , Manhasset , NY , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2025,10,20]]},"reference":[{"key":"2026051215204229933_j_jpm-2025-0137_ref_001","doi-asserted-by":"crossref","unstructured":"McDonald, IA. 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