History-indicated cerclage: practice patterns of maternal-fetal medicine specialists in the USA
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Nathan S. Fox
Abstract
Objective: There is limited evidence supporting the effectiveness of history-indicated cerclage in preventing spontaneous pregnancy loss or preterm birth. This study was undertaken to estimate the practice patterns of maternal-fetal medicine specialists in regards to history-indicated cerclage.
Methods: We performed a mail-based survey of all SMFM specialists in the US. Subjects were asked whether they would recommend a history-indicated cerclage at 12–14 weeks in a patient whose prior pregnancy was her first pregnancy and ended in a spontaneous, painless loss at 19 weeks with no identifiable cause.
Results: A total of 827 (46%) of SMFM members responded of which 75% would recommend a history-indicated cerclage for this patient. Twenty-one percent would not recommend one, but would place one if desired by the patient. Only 4% would not place a history-indicated cerclage in this scenario. A total of 71% believed a history-indicated cerclage was associated with moderate or significant benefit, and 89% believed it involved minimal or no risk. Female gender, non-academic practice, practicing in the southern region and greater interval since residency training were all independently associated with the recommendation for a history-indicated cerclage.
Conclusions: Despite limited level-I evidence supporting its use, a history-indicated cerclage is recommended by most maternal-fetal medicine specialists.
©2008 by Walter de Gruyter Berlin New York
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- Umbilical cord thickness in the first and early second trimesters and perinatal outcome
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- Original article – Newborn
- Neonatal neurological morbidity associated with uterine rupture
- Short communication
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- Letters to the editor
- Milk of women with lifetime consumption of the recommended daily intake of fish fatty acids should constitute the basis for the DHA contents of infant formula
- Reversible facial nerve palsy secondary to nasal continuous positive airway pressure
- Optimal timing of elective cesarean delivery for twins
- Congress Calendar
- Congress Calendar
- Index Volume 36 (2008)
- Index Volume 36 (2008) - Contents
- Index - Subjects
- Index - Subjects
- Index - Authors
- Index - Authors
- Acknowledgement
- Acknowledgement
Articles in the same Issue
- Expert panel recommendation
- Diagnosis and treatment of peripartum bleeding
- Original articles – Obstetrics
- Transvaginal ultrasonographic measurement of cervical length in predicting intra-amniotic infection and impending preterm delivery in preterm labor: a comparison with amniotic fluid white blood cell count
- Visfatin/Pre-B cell colony-enhancing factor in amniotic fluid in normal pregnancy, spontaneous labor at term, preterm labor and prelabor rupture of membranes: an association with subclinical intrauterine infection in preterm parturition
- The antenatal identification of funisitis with a rapid MMP-8 bedside test
- Can neonatal myasthenia gravis be predicted?
- Blood loss in low-lying placenta: placental edge to cervical internal os distance of less vs. more than 2 cm
- History-indicated cerclage: practice patterns of maternal-fetal medicine specialists in the USA
- Original article – Fetus
- Jugular lymphatic sacs in the first trimester of pregnancy: the prevalence and the potential value in screening for chromosomal abnormalities
- Umbilical cord thickness in the first and early second trimesters and perinatal outcome
- Sex-specific charts for abdominal circumference in term and near-term Caucasian newborns
- Prediction of adverse perinatal outcome at term in small-for-gestational age fetuses: comparison of growth velocity vs. customized assessment
- Original article – Newborn
- Neonatal neurological morbidity associated with uterine rupture
- Short communication
- Long-term epidural block treatment in patients with early threatening preterm delivery and vaginal fetal engagement
- Letters to the editor
- Milk of women with lifetime consumption of the recommended daily intake of fish fatty acids should constitute the basis for the DHA contents of infant formula
- Reversible facial nerve palsy secondary to nasal continuous positive airway pressure
- Optimal timing of elective cesarean delivery for twins
- Congress Calendar
- Congress Calendar
- Index Volume 36 (2008)
- Index Volume 36 (2008) - Contents
- Index - Subjects
- Index - Subjects
- Index - Authors
- Index - Authors
- Acknowledgement
- Acknowledgement
