From: Reducing stillbirths: prevention and management of medical disorders and infections during pregnancy
Source | Location and Type of Study | Intervention | Stillbirths/Perinatal Outcomes |
---|---|---|---|
Reviews and meta-analyses | Â | Â | Â |
Drakeley et al. 2003 [92] | Netherlands, France, UK, South Africa. Meta-analysis (Cochrane). 6 RCTs included (N = 2059 women). | Assessed the effects of cervical cerclage (intervention) vs. no cerclage (controls). | PMR: RR = 0.80 (95% CI: 0.48–1.36) [NS] [24/1035 vs. 31/1024 in intervention vs. control groups, respectively. |
Jorgensen et al. 2007 [100] | Netherlands, USA, Nigeria, UK, France, Hungary, Norway, Italy, Belgium, Zimbabwe, South Africa, Iceland, Ireland, Canada, Brazil Slovenia, Greece and Chile. Meta-analysis. 7 RCTs included (N = 2091 women). | Assessed the effects of cervical cerclage (intervention) vs. no cerclage (controls). | (Singleton gestations) Pregnancy loss or death before hospital discharge: OR = 0.81 (95% CI: 0.60–1.10) [NS] (Multiple gestations) Pregnancy loss or death before hospital discharge: OR = 5.88 (95% CI: 1.14–30.19). |
Intervention studies | Â | Â | Â |
Blair et al. 2002 [101] | West Indies. RCT. Pregnant women (N = 50) with cervical incompetence. | Compared the impact of cervical cerclage between inpatient care for 3 days post-procedure, spending 3 days in hospital post-procedure (intervention) vs. outpatient bed rest (controls). Both groups given salbutamol tablets postoperatively for tocolysis. | Live birth rate: 20/23 vs. 18/23 (86.9% vs. 78.3%) in intervention vs. control groups, respectively [NS] |
Jaswal et al. 2006 [198] | India. Quasi-RCT. Pregnant women (N = 37) being expectantly managed for placenta previa. | Compared the impact of cervical cerclage (intervention) versus no cerclage (controls). | PMR: 0/18 vs. 8/19 in intervention vs. control groups, respectively (P < 0.01). |
Observational studies | Â | Â | Â |
Debbs et al. 2007 [104] | USA. Retrospective case series. Pregnant women (N = 75) with negative evaluation for recurrent pregnancy loss and ≥ 1 previous unsuccessful transvaginal cerclage. | Assessed the impact of transabdominal cerclage on birth outcomes. | Live birth rate: 96% after transabdominal cerclage. |
Fick et al. 2007 [102] | USA. A cohort study. Pregnant women (N = 88 women; N = 9 pregnancies) with transabdominal cerclage. | Compared the live birth rate before and after transabdominal cerclage. | Live birth rate: 93% vs. 18% after vs. cerclage, respectively; P < 0.001). |
Gesson-Paute et al. 2007 [103] | France. Retrospective study. Transabdominal cerclages (N = 12) performed from 1988–2005. | Compared the live birth rate during the period where transabdominal cerclage was performed vs. the pre-cerclage period. | Live birth rate: 93% vs. 17% after vs. before cerclage, respectively. |