title: Cervical length < or = 25 mm in low-risk women: a case control study of cerclage with rest vs rest alone.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the clinical utility of cerclage in low risk women with cervical length (CL) < or = 25 mm at transvaginal ultrasound (TVU).
  
  
  METHODS
  This was a retrospective cohort study of women with CL < or = 25 mm identified incidentally at TVU examinations between 16(0/7) to 24(6/7) weeks, with no history of previous preterm birth or midtrimester losses. The primary study outcome was rate of preterm delivery < 35 weeks' gestation.
  
  
  RESULTS
  Women undergoing cerclage placement (n = 31) had shorter CL (P < .001) and lower gestational age at presentation (P < .001) than those managed with rest alone (n = 36). Gestational age at delivery was 37.6 +/- 3.6 vs 38.5 +/- 2.1 weeks (P = .17), and delivery at < 35 weeks occurred in 5/31 versus 2/36 cases, respectively (P = .23). The lack of a significant association between cerclage and rate of delivery < 35 weeks persisted after controlling for gestational age at TVU and initial CL (P = .81).
  
  
  CONCLUSIONS
  Cerclage placement does not improve pregnancy outcome in low-risk women with incidental detection of CL < or = 25 mm in the early second trimester.
authors.affiliation: Department of Obstetrics and Gynecology, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy.
authors.forename: Maddalena
authors.initials: M
authors.lastname: Incerti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ghidini
authors.forename: Anna
authors.initials: A
authors.lastname: Locatelli
authors.forename: Sarah H
authors.initials: SH
authors.lastname: Poggi
authors.forename: John C
authors.initials: JC
authors.lastname: Pezzullo
mesh_terms: D000328:Adult; D001510:Bed Rest; D001837:Body Weights and Measures; D016022:Case-Control Studies; D023802:Cerclage, Cervical; D002584:Cervix Uteri / Q000648:ultrastructure*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D047928:Premature Birth / Q000517:prevention & control*; D012189:Retrospective Studies; D014463:Ultrasonography; D002581:Uterine Cervical Incompetence / Q000000981:diagnostic imaging / Q000601:surgery*