Controversies regarding cervical incompetence, short cervix, and the need for cerclage
Date
2004
Authors
Althuisius, S.
Dekker, G.
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Journal article
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Clinics in Perinatology, 2004; 31(4):695-720
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Abstract
Cervical incompetence (CI) is not an all or nothing phenomenon but a continuous variable. CI and preterm labor are not distinct entities but rather part of a spectrum leading to preterm delivery. Cervical length (CL) is an independent variable in the prediction of preterm delivery, to which it is inversely related. Application of a primary transvaginal cervical cerclage appears to be an unnecessary intervention in about 50% of women presenting with a history suggesting cervical incompetence. A better alternative for women with a history of or risk factors for CI is transvaginal ultrasonographic follow-up of CL. To facilitate the comparison of studies of CI, the authors suggest a nomenclature reflecting the different stages of prevention: primary, secondary, and tertiary transvaginal cervical cerclage.
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Copyright © 2004 Elsevier Inc.