title: Amniocentesis prior to physical exam-indicated cerclage in women with midtrimester cervical dilation: results from the expectant management compared to Physical Exam-indicated Cerclage international cohort study.
abstract: We evaluated whether the performance of an amniocentesis in women with a dilated cervix presenting at less than 26 weeks and subsequently managed by a physical exam-indicated cerclage increases the risk of spontaneous preterm birth (PTB) less than 28 weeks. Women between 15 (0)/ (7) to 25 (6)/ (7) weeks' gestation with a dilated cervix (1 to 4 cm) were identified. Multiple exclusion criteria were designated. The primary outcome was PTB less than 28 weeks. One hundred twenty-two women with a dilated cervix between 15 and 25 (6)/ (7) weeks gestational age were identified. Twenty-four (20%) of these had an amniocentesis performed. The unadjusted rate of PTB < 28 weeks differed between women who underwent amniocentesis compared with those who did not (58% versus 34%, respectively, P = 0.02), but after multivariate regression analysis, the performance of an amniocentesis was not an independent contributor to PTB < 28 weeks ( P = 0.90). The performance of an amniocentesis prior to cerclage did not independently contribute to PTB less than 28 weeks.
authors.affiliation: Thomas Jefferson University, Philadelphia, Pennsylvania, USA. airoldj@slhn.org
authors.forename: James
authors.initials: J
authors.lastname: Airoldi
authors.forename: Leonardo
authors.initials: L
authors.lastname: Pereira
authors.forename: Amanda
authors.initials: A
authors.lastname: Cotter
authors.forename: Ricardo
authors.initials: R
authors.lastname: Gomez
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Berghella
authors.forename: Witoon
authors.initials: W
authors.lastname: Prasertcharoensuk
authors.forename: Juha
authors.initials: J
authors.lastname: Rasanen
authors.forename: Surasith
authors.initials: S
authors.lastname: Chaithongwongwatthana
authors.forename: Suneeta
authors.initials: S
authors.lastname: Mittal
authors.forename: Etaion
authors.initials: E
authors.lastname: Kearney
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Tolosa
mesh_terms: D000328:Adult; D000649:Amniocentesis; D023802:Cerclage, Cervical; D015331:Cohort Studies; D005321:Extraembryonic Membranes / Q000473:pathology; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000209:etiology; D005674:Fusobacterium Infections / Q000150:complications; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007747:Labor Stage, First / Q000502:physiology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D047928:Premature Birth / Q000209:etiology* / Q000517:prevention & control; D012008:Recurrence; D017584:Reproductive History; D012307:Risk Factors; D016869:Ureaplasma Infections / Q000150:complications