Qin Chen1, Guiying Chen2, Nan Li3. 1. Department of Obstetrica, Tengzhou Central People's Hospital, No. 181 Xingtan Road, Tengzhou, 277599, Shandong, China. qinchen4321@sina.com. 2. Department of Pharmacy, Tengzhou Central People's Hospital, Tengzhou, 277599, China. 3. Department of Obstetrica, Tengzhou Central People's Hospital, No. 181 Xingtan Road, Tengzhou, 277599, Shandong, China.
Abstract
PURPOSE: To compare the clinical effect of emergency cervical cerclage and elective cervical cerclage on pregnancy outcome in the cervical-incompetent pregnant women. METHODS: Literature was searched from the databases of Pubmed, Embase and Google scholar. The fixed or random effects model was used to calculate pooled risk ratios on the basis of heterogeneity. Meta-regression, sensitive analysis, subgroup analysis, and publication bias assessment were also conducted to confirm the results according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009. RESULTS: The meta-analysis results showed that there were significant associations between cerclage operations and pregnancy outcomes in gestation age, birth weight, and PROM rate. Gestation age was significantly higher in women with elective cerclage than those with emergency cerclage, and birth weight was significantly higher in newborns for the elective group as compared with emergency group. The rate of PROM in elective group was lower than emergency group. However, there were no differences between the emergency cerclage group and the elective cerclage group regarding the rate of vaginal delivery. CONCLUSIONS: This meta-analysis suggests that emergency cerclage has lower gestation age and birth weight than elective cerclage, and it increases the risk of PROM. Further well-designed studies are warranted to confirm these results.
PURPOSE: To compare the clinical effect of emergency cervical cerclage and elective cervical cerclage on pregnancy outcome in the cervical-incompetent pregnant women. METHODS: Literature was searched from the databases of Pubmed, Embase and Google scholar. The fixed or random effects model was used to calculate pooled risk ratios on the basis of heterogeneity. Meta-regression, sensitive analysis, subgroup analysis, and publication bias assessment were also conducted to confirm the results according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009. RESULTS: The meta-analysis results showed that there were significant associations between cerclage operations and pregnancy outcomes in gestation age, birth weight, and PROM rate. Gestation age was significantly higher in women with elective cerclage than those with emergency cerclage, and birth weight was significantly higher in newborns for the elective group as compared with emergency group. The rate of PROM in elective group was lower than emergency group. However, there were no differences between the emergency cerclage group and the elective cerclage group regarding the rate of vaginal delivery. CONCLUSIONS: This meta-analysis suggests that emergency cerclage has lower gestation age and birth weight than elective cerclage, and it increases the risk of PROM. Further well-designed studies are warranted to confirm these results.