History-indicated cerclage: practice patterns of maternal-fetal medicine specialists in the USA. Academic Article uri icon

Overview

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.

publication date

  • January 1, 2008

Research

keywords

  • Cerclage, Cervical
  • Obstetrics
  • Practice Patterns, Physicians'
  • Prenatal Care

Identity

Scopus Document Identifier

  • 55749113196

Digital Object Identifier (DOI)

  • 10.1515/JPM.2008.083

PubMed ID

  • 18651834

Additional Document Info

volume

  • 36

issue

  • 6