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Re: Cerclage For Short Cervix From: Efrain Ramirez (eramirezt@coqui.net) Fri Jun 4 23:50:10 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Efrain Ramirez: "Re: large uterine fibroids and natural labor" Previous message: Steve & Eryl Raymond: "Re: Cerclage For Short Cervix" Do you Fetal Fibronectin? >At Fri, 4 Jun 2004, Lynn D. Montgomery, M.D. wrote: > >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 > -- "The opposite of a correct statement is a false statement. But the opposite of a profound truth may well be another profound truth." Niels Bohr (1885 - 1962) Next message: Efrain Ramirez: "Re: large uterine fibroids and natural labor" Previous message: Steve & Eryl Raymond: "Re: Cerclage For Short Cervix"

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