EP19.23: Postoperative cervical length for predicting success of repeat cerclage in singleton pregnancy with prolapsed membrane following prior cerclage

Le résumé fourni par la source

- To evaluate the outcome of repeat cerclage in singleton pregnancy with prolapsed membrane following prior cerclage. - To analyse predictive factors for delivery > 26 weeks following repeat cerclage. Patients who underwent repeat cerclage (RC) from 2010 and 2020 at Hallym University Medical Center were reviewed. Women with singleton pregnancy with prolapsed membrane following prior cerclage were candidates for repeat cerclage. We analysed characteristics, pregnancy outcomes, perioperative clinical and laboratory findings, and postoperative cervical length (CL) to enlighten the factors for predicting delivery ≧ 26 weeks following repeat cerclage. Thirty-five women with repeat cerclage were identified: The mean gestational age (GA) at prior cerclage was 14 weeks; The average GA at repeat cerclage (RC) was 21 weeks; The mean GA at delivery following RC was 26 weeks. Patients were divided into two groups according to delivery 26 weeks: 17 women delivered at < 26 weeks (range 18-25 weeks) (group A); 18 women delivered at ≧ 26weeks (range 26-40 weeks) (group B). The average GA at delivery in group A was 22 weeks, whereas the mean GA at delivery in group B was 33 weeks (p < 0.001). There were no differences in preoperative clinical and laboratory findings between two groups. However, postoperative cervical length (CL) in group A was significantly shorter than group B (12mm vs. 21.5mm, p < 0.001). ROC curve of postoperative CL predicting delivery ≧ 26 weeks showed AUC 0.843: CL 20mm showed sensitivity 61.1% and specificity 100%. Repeat cerclage might prolong singleton pregnancy with prolapsed membrane following prior cerclage. Postoperative cervical length ≧ 20mm might predict the success of repeat cerclage.

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