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  • Title: Predictive score for early preterm birth in decisions about emergency cervical cerclage in singleton pregnancies.
    Author: Fuchs F, Senat MV, Fernandez H, Gervaise A, Frydman R, Bouyer J.
    Journal: Acta Obstet Gynecol Scand; 2012 Jun; 91(6):744-9. PubMed ID: 22375688.
    Abstract:
    OBJECTIVE: To develop a simple score for assessing the risk of early preterm delivery before 32 weeks in women with singleton pregnancies receiving emergency cervical cerclage. DESIGN: Retrospective study. SETTING: French tertiary care center from 1994 to 2006. POPULATION: A total of 134 pregnant women underwent emergency cervical cerclage procedure at 15-26 weeks. The analysis concerned 85 singleton pregnancies after exclusion of women with a dilated cervix without visible membranes, or presenting for revision of failed prophylactic cerclage, or who had either preterm premature rupture of membranes or clinical signs of chorioamnionitis. METHODS: Multivariate logistic regression methods with rounded coefficients were used to develop a score to predict early preterm delivery before 32 weeks. MAIN OUTCOME MEASURES: Early preterm delivery before 32 weeks. RESULTS: The score, ranging from 0 to 15 points, was based on the following four criteria independently associated with early preterm delivery: obstetric history; cervical dilatation; membranes bulging into the vagina; and infection. Each score value was associated with a predicted probability of early preterm birth. CONCLUSIONS: The score and its associated early preterm probabilities may be a valuable tool to help physicians in advising women about the need for emergency cerclage.
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