875 Cerclage in Singletons with a Short Cervix (≤10mm) and No History of Spontaneous Preterm Birth

To determine whether cervical cerclage is associated with an increased time interval to delivery in women with an asymptomatic short cervical length (CL ≤10mm) and no history of spontaneous preterm birth (sPTB). Multicenter retrospective cohort of women with CL ≤10mm between 16 and 23 weeks’ gestation from January 2014 to December 2019. Women with prior sPTB, symptoms of preterm labor, cervical dilation > 1cm, pessary or missing data were excluded. The primary outcome was time interval from diagnosis to delivery. Secondary outcomes included various PTB cut-offs and adverse neonatal outcomes. A sub-group analysis of all outcomes on patients already treated with vaginal progesterone in each group was also performed. Statistical analysis included Chi-squared and Wilcoxon rank-sum tests, as well as a multivariate Cox proportional hazard regression for time interval to delivery. Of the 90 patients included, 52 (57.8%, 35 already treated with progesterone) had cervical cerclage and 38 (42.2%, 21 already treated with progesterone) did not. Baseline characteristics of the two groups are displayed in Table 1. Cervical cerclage was associated with a longer time interval to delivery (14.5 weeks vs. 12.4 weeks; P = 0.02; Table 2) and lower likelihood of delivery (aHR 0.61, 95% CI 0.38-0.99; P = 0.04) compared to no cerclage, after accounting for gestational age and CL at diagnosis. In patients already treated with progesterone, cervical cerclage was also associated with a longer time interval to delivery (15.1 weeks vs. 11.3 weeks, P = 0.01; Table 2) and lower likelihood of delivery (aHR 0.47, 95% CI 0.26-0.87, P = 0.01) compared to no cerclage. Cervical cerclage was also associated with a lower rate of late PTB compared to no cerclage (11.5% vs. 31.6%, P = 0.03) (Table 2). Cervical cerclage should be considered in asymptomatic women with an extremely short CL (≤10mm) and no history of sPTB.View Large Image Figure ViewerDownload Hi-res image Download (PPT)