Cervical cerclage for the temporary treatment of patients with placenta previa.
Cervical cerclage as a temporizing measure for the treatment of patients with placenta previa was evaluated in 25 patients admitted to the hospital for vaginal bleeding between 24-30 weeks' gestation and sonographic evidence of a placenta previa. The patients were randomly assigned to either cerclage (13) or conventional management (12). Cerclage patients had significantly better perinatal outcome, as indicated by more advanced gestational age at the time of delivery (34.9 +/- 3.0 versus 31.6 +/- 2.9 weeks; P = .02), larger birth weight (2709 +/- 511 versus 1812 +/- 506 g; P = .002), and fewer neonatal complications (two of 13 versus ten of 12 infants; P = .001). Maternal bleeding was more frequent and severe for patients in the control group. The total hospital cost was less for cerclage patients than for those receiving conventional expectant management ($9898 +/- 3943 versus $27,271 +/- 9901; P = .02). These results support the use of cervical cerclage for the treatment of patients with symptomatic placenta previa early in gestation.
Arias
F
F
St. John's Mercy Medical Center, St. Louis, Missouri.
D001803:Blood Transfusion; D002584:Cervix Uteri / Q000601:surgery*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000150:complications; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal / Q000191:economics; D010923:Placenta Previa / Q000150:complications / Q000601:surgery* / Q000628:therapy; D011247:Pregnancy; D011256:Pregnancy Outcome; D013997:Time Factors; D014592:Uterine Hemorrhage / Q000209:etiology