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Re: Cerclage For Short Cervix From: Lynn D. Montgomery, M.D. (apgar10@montanadsl.net) Fri Jun 4 11:08:38 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Steve & Eryl Raymond: "Re: IUFD Management" Previous message: Seele, Mona: "Re: IUFD Management" In reply to: art fougner, md: "OB: Cerclage For Short Cervix" Next in thread: Steve & Eryl Raymond: "Re: Cerclage For Short Cervix" Reply: Steve & Eryl Raymond: "Re: Cerclage For Short Cervix" Art, This seems to be the finding of several studies. What seems to be the most advantageous route of follow for patient's with a known shortened cervix (< 2.5 cm between 16-20 weeks) is weekly measurement of the cervix until at least 24 weeks and only placing a stitch in those who demonstrate a "dynamic" change (either further shortening or funneling). This seems to lessen the number of unnecessary cerclages and also the risk of preterm birth imparted by simply placing a cerclage. The disadvantage is the weekly visits for cervical measurement. Lynn -- Lynn D. Montgomery, M.D. Maternal-Fetal Medicine, OB/GYN Rocky Mountain Women's Health 2835 Fort Missoula Rd., Suite 303 Missoula, Montana, 59804 406-549-0978 fax 406-549-0987 e-mail: apgar10@montanadsl.net -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of art fougner, md Sent: Friday, June 04, 2004 5:42 AM To: Multiple recipients of list OB-GYN-L Subject: OB: Cerclage For Short Cervix >From "The Lancet" The future of cervical suture 'The insertion of a Shirodkar suture in women with a short cervix does not substantially reduce the risk of early preterm delivery' Cervical cerclage has been widely used to prevent preterm birth and its associated neonatal mortality and morbidity. Meekai To and colleagues aimed to test the hypothesis that cervical cerclage in women with a short cervix is associated with a three-fold reduction in early preterm delivery. Although routine transvaginal sonographic measurement of cervical length at 22-24 weeks' gestation identifies a group at high risk of early preterm delivery, the investigators conclude that insertion of a Shirodkar suture in such women does not substantially reduce the risk of prematurity. Lancet Volume 363, Number 9424 05 June 2004 Cervical cerclage for prevention of preterm delivery in women with short cervix: randomised controlled trial Meekai S To, Zarko Alfirevic, Victoria C F Heath, Simona Cicero, Ana Maria Cacho, Paula R Williamson, Kypros H Nicolaides, on behalf of the Fetal Medicine Foundation Second Trimester Screening Group* art -- art fougner, md ich bin ein New Yorker Next message: Steve & Eryl Raymond: "Re: IUFD Management" Previous message: Seele, Mona: "Re: IUFD Management" In reply to: art fougner, md: "OB: Cerclage For Short Cervix" Next in thread: Steve & Eryl Raymond: "Re: Cerclage For Short Cervix" Reply: Steve & Eryl Raymond: "Re: Cerclage For Short Cervix"

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