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  • Title: Amniocentesis prior to physical exam-indicated cerclage in women with midtrimester cervical dilation: results from the expectant management compared to Physical Exam-indicated Cerclage international cohort study.
    Author: Airoldi J, Pereira L, Cotter A, Gomez R, Berghella V, Prasertcharoensuk W, Rasanen J, Chaithongwongwatthana S, Mittal S, Kearney E, Tolosa JE.
    Journal: Am J Perinatol; 2009 Jan; 26(1):63-8. PubMed ID: 18979415.
    Abstract:
    We evaluated whether the performance of an amniocentesis in women with a dilated cervix presenting at less than 26 weeks and subsequently managed by a physical exam-indicated cerclage increases the risk of spontaneous preterm birth (PTB) less than 28 weeks. Women between 15 (0)/ (7) to 25 (6)/ (7) weeks' gestation with a dilated cervix (1 to 4 cm) were identified. Multiple exclusion criteria were designated. The primary outcome was PTB less than 28 weeks. One hundred twenty-two women with a dilated cervix between 15 and 25 (6)/ (7) weeks gestational age were identified. Twenty-four (20%) of these had an amniocentesis performed. The unadjusted rate of PTB < 28 weeks differed between women who underwent amniocentesis compared with those who did not (58% versus 34%, respectively, P = 0.02), but after multivariate regression analysis, the performance of an amniocentesis was not an independent contributor to PTB < 28 weeks ( P = 0.90). The performance of an amniocentesis prior to cerclage did not independently contribute to PTB less than 28 weeks.
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