title: Risk of intrapartum cervical lacerations in women with cerclage.
abstract: OBJECTIVE
  The aim of our study was to estimate whether the placement of cerclage in pregnancy to prevent preterm birth (PTB) is associated with higher incidence of intrapartum cervical lacerations.
  
  
  METHODS
  A retrospective cohort study was conducted on singleton pregnancies with risk factors for PTB. The study group consisted of women with either a history- or ultrasound-indicated cerclage placed between 12 and 24 weeks of gestation, while the control group consisted of women with similar risk factors for PTB but who did not receive a cerclage. Primary outcome was the incidence of intrapartum cervical lacerations. A sample size calculation was performed on the basis of the results of previous studies on cervical lacerations.
  
  
  RESULTS
  We identified 134 women who had a cerclage placed in pregnancy. They were compared with 236 controls with no cerclage. Cases and controls had similar risk factors for cervical lacerations. Cervical lacerations occurred with similar frequencies in the cerclage and no-cerclage group (2.2 vs 1.3%, p = 0.78). There was no significant difference between the two groups for the risk of cervical lacerations (RR 1.76, 95% CI: 0.36-8.60).
  
  
  CONCLUSIONS
  Cerclage placement during pregnancy is not associated with an increased risk of intrapartum cervical lacerations.
authors.affiliation: Department of Science for Woman and Child's Health, University of Florence, Florence, Italy. violaseravalli@gmail.com
authors.forename: Viola
authors.initials: V
authors.lastname: Seravalli
authors.forename: Sushma
authors.initials: S
authors.lastname: Potti
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Berghella
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D023802:Cerclage, Cervical / Q000009:adverse effects* / Q000706:statistics & numerical data; D002584:Cervix Uteri / Q000293:injuries*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D022125:Lacerations / Q000453:epidemiology / Q000209:etiology*; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000209:etiology*; D036801:Parturition / Q000502:physiology; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D002581:Uterine Cervical Incompetence / Q000453:epidemiology / Q000601:surgery; D055815:Young Adult