Yijun Liu1, Meng Chen2, Tiantian Cao1, Shuai Zeng1, Ruixin Chen1, Xinghui Liu3. 1. West China Second Hospital, Sichuan University, Department of Gynecology and Obstetrics, Chengdu, 610041, China. 2. West China Second Hospital, Sichuan University, Department of Gynecology and Obstetrics, Chengdu, 610041, China; West China Second Hospital, Sichuan University, Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Chengdu, 610041, China. 3. West China Second Hospital, Sichuan University, Department of Gynecology and Obstetrics, Chengdu, 610041, China; West China Second Hospital, Sichuan University, Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Chengdu, 610041, China. Electronic address: xinghuiliu@163.com.
Abstract
OBJECTIVE: Data on the prevention of preterm birth in twin pregnancies with cervical cerclage remain inconsistent. Thus, this study aimed to comprehensively evaluate the value of cervical cerclage as a treatment strategy to prevent preterm birth in twin pregnancies with regard to both maternal and neonatal outcomes. STUDY DESIGN: In this systematic review and meta-analysis, the PubMed, Cochrane Library, Medline, EMBASE, and Web of Science databases were searched for relevant studies and trials from their inception up to December 2020. Outcomes were expressed as risk ratios and standardized mean differences in a meta-analysis model using STATA 15.0 software. RESULTS: The search included 944 studies, 15 of which were eligible for inclusion, representing 726 patients treated with cervical cerclage and 8578 non-cerclage treatment controls. When the cervical length was <15 mm, the risk ratio of preterm birth at <37 weeks (0.77, p = 0.01), <34 weeks (0.58, p = 0.002), and <32 weeks (0.61, p = 0.024) of gestation in the cerclage group was significantly lower than that in the non-cerclage group. CONCLUSION: For twin pregnancies with a cervical length <15 mm, cervical cerclage was associated with significant reduction in preterm birth.
OBJECTIVE: Data on the prevention of preterm birth in twin pregnancies with cervical cerclage remain inconsistent. Thus, this study aimed to comprehensively evaluate the value of cervical cerclage as a treatment strategy to prevent preterm birth in twin pregnancies with regard to both maternal and neonatal outcomes. STUDY DESIGN: In this systematic review and meta-analysis, the PubMed, Cochrane Library, Medline, EMBASE, and Web of Science databases were searched for relevant studies and trials from their inception up to December 2020. Outcomes were expressed as risk ratios and standardized mean differences in a meta-analysis model using STATA 15.0 software. RESULTS: The search included 944 studies, 15 of which were eligible for inclusion, representing 726 patients treated with cervical cerclage and 8578 non-cerclage treatment controls. When the cervical length was <15 mm, the risk ratio of preterm birth at <37 weeks (0.77, p = 0.01), <34 weeks (0.58, p = 0.002), and <32 weeks (0.61, p = 0.024) of gestation in the cerclage group was significantly lower than that in the non-cerclage group. CONCLUSION: For twin pregnancies with a cervical length <15 mm, cervical cerclage was associated with significant reduction in preterm birth.