{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T22:03:53Z","timestamp":1780869833584,"version":"3.54.1"},"reference-count":22,"publisher":"Walter de Gruyter GmbH","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>\n                  <jats:bold>Objective:<\/jats:bold> To determine pregnancy outcome in patients with short cervix on transvaginal ultrasound between 16 and 24\u00a0weeks' gestation treated with McDonald cerclage compared to weekly intramuscular injections of 17 \u03b1-hydroxyprogesterone caproate (17OHP-C).<\/jats:p>\n               <jats:p>\n                  <jats:bold>Methods:<\/jats:bold> From November 2003 through December 2006, asymptomatic, singleton pregnancies were screened with transvaginal ultrasound between 16\u201324 weeks' gestation. Patients with a cervical length (CL) \u226425\u00a0mm were offered enrollment. Patients were randomly assigned to treatment with McDonald cerclage or weekly intramuscular injections of 17OHP-C. The primary outcome was spontaneous preterm birth (PTB) prior to 35\u00a0weeks' gestation.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Results:<\/jats:bold> Seventy-nine patients met inclusion criteria; 42 were randomly assigned to the cerclage and 37 to 17OHP-C. Spontaneous PTB prior to 35\u00a0weeks' gestation occurred in 16\/42 (38.1%) of the cerclage group and in 16\/37 (43.2%) of the 17OHP-C group (relative risk, 1.14 95% CI, 0.67, 1.93). A post hoc analysis of patients with a prior PTB showed no difference in spontaneous PTB &lt;35\u00a0weeks between groups. A similar analysis of patients with a CL\u226415\u00a0mm showed a reduction in spontaneous PTB &lt;35\u00a0weeks in the cerclage group (relative risk 0.48, 0.24\u20130.97).<\/jats:p>\n               <jats:p>\n                  <jats:bold>Conclusion:<\/jats:bold> Women with CL \u226425\u00a0mm in the second-trimester appear to have similar risks of delivering prior to 35\u00a0weeks' gestation when treated with 17OHP-C or McDonald cerclage. However, cerclage may be more effective in preventing spontaneous PTB in women with CL\u226415\u00a0mm.<\/jats:p>","DOI":"10.1515\/jpm.2009.083","type":"journal-article","created":{"date-parts":[[2009,6,3]],"date-time":"2009-06-03T12:17:39Z","timestamp":1244031459000},"page":"473-479","source":"Crossref","is-referenced-by-count":57,"title":["A randomized trial of cerclage vs. 17 \u03b1-hydroxyprogesterone caproate for treatment of short cervix"],"prefix":"10.1515","volume":"37","author":[{"given":"Sean M.","family":"Keeler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Kiefer","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, Winthrop University Hospital, Mineola, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith","family":"Rochon","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, Lehigh Valley Health Network, Allentown, PA, 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