title: Double versus single cervical cerclage for patients with recurrent pregnancy loss: a randomized clinical trial.
abstract: OBJECTIVE
  To compare the effectiveness of the double cervical cerclage method versus the single method in women with recurrent second-trimester delivery.
  
  
  METHODS
  In this randomized clinical trial, we included 33 singleton pregnancies suffering from recurrent second-trimester pregnancy loss (≥2 consecutive fetal loss during second-trimester or with a history of unsuccessful procedures utilizing the McDonald method), due to cervical incompetence. Patients were randomly assigned to undergo either the classic McDonald method (n = 14) or the double cerclage method (n = 19). The successful pregnancy rate and gestational age at delivery was also compared between the two groups.
  
  
  RESULTS
  The two study groups were comparable regarding their baseline characteristics. The successful pregnancy rate did not differ significantly between those who underwent the double cerclage method or the classic McDonald cerclage method (100% vs 85.7%; P = 0.172). In the same way, the preterm delivery rate (<34 weeks of gestation) was comparable between the two study groups (10.5% vs 35.7%; P = 0.106). Those undergoing the double cerclage method had longer gestational duration (37.2 ± 2.6 vs 34.3 ± 3.8 weeks; P = 0.016).
  
  
  CONCLUSIONS
  The double cervical cerclage method seems to provide better cervical support, as compared with the classic McDonald cerclage method, in those suffering from recurrent pregnancy loss, due to cervical incompetence.
authors.affiliation: Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Jaleh
authors.initials: J
authors.lastname: Zolghadri
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Younesi
authors.forename: Nasrin
authors.initials: N
authors.lastname: Asadi
authors.forename: Dezire
authors.initials: D
authors.lastname: Khosravi
authors.forename: Shabnam
authors.initials: S
authors.lastname: Behdin
authors.forename: Zohre
authors.initials: Z
authors.lastname: Tavana
authors.forename: Fariborz
authors.initials: F
authors.lastname: Ghaffarpasand
mesh_terms: D000328:Adult; D023802:Cerclage, Cervical / Q000379:methods*; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D047928:Premature Birth / Q000209:etiology; D012008:Recurrence; D002581:Uterine Cervical Incompetence / Q000601:surgery*
keywords: cervical incompetence; classic McDonald cerclage; double cerclage; recurrent pregnancy loss