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LONDON (Reuters Health), Fri Jun 4, 2004
Although cervical cerclage,
as the strategy is called, has been widely used for 50 years,
results of clinical trials have
not supported the value of the practice, Professor Kypros H.
Nicolaides from Kings College Hospital, London, and colleagues
note in this week's issue of The Lancet.
This may have been
because patients were deemed to be at risk for preterm delivery
based largely on previous occurrences, they suggest. In their
study, the investigators used ultrasound to screen 47,123 women
and identified 470 with a short cervix that indicated a risk
for early delivery.
The team then randomly assigned 253 of
these women to have cervical cerclage or no surgery. The aim
of the study was to test the theory that cervical cerclage
would result in a three-fold reduction in early preterm delivery.
At the end of their study, the authors found that 22 percent
of women randomized to cerclage delivered before 33 weeks,
compared with 26 percent of the women in the control group.
The difference in these rates was not significant statistically,
meaning it could have occurred by chance.
The rate of early
preterm delivery in both groups was far in excess of the UK
average of 1.5 percent, highlighting the efficiency of the
ultrasound measurement for identifying high-risk women, the
researchers note.
However, they conclude, the findings also
show that, "in women with a short cervix at 22 to 24 weeks
of gestation, the insertion of a (cervical) suture does not
result in a three-fold reduction in the frequency of early
preterm delivery."
SOURCE: Lancet, June 5, 2004.
© Copyright
Reuters 2004
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