Pregnancy outcomes after cerclage placement in nulliparous women with a short cervix on transvaginal ultrasonography

Objective: Little is known about pregnancy outcomes associated with a short cervix and cerclage placement in nulliparous women.Methods: An electronic query of our ultrasound database was used to identify patients whose cervical length measured <25mm between 16-24 weeks of gestation. Any nulliparous women, with no prior pregnancy lasting beyond 13 weeks 6 d gestational age, were included in the analysis. The primary outcome was the interval of time from the diagnosis of a short cervix (<25mm) to the time of delivery.Results: Our query identified 70 patients for analysis. The interval of time from diagnosis of a short cervix to delivery was observed to be 85 d (12.1 weeks) in the cerclage group and 116 d (16.6 weeks) in the expectantly managed group (p=0.02). In those women receiving a cerclage, there was a statistically significant risk of spontaneous preterm birth <32 weeks gestational age (R.R. 6.7 [95% CI 1.45-30.6]).Conclusions: The impact of a short cervix is largely unknown in patients with an uncomplicated obstetrical history. Our investigation would suggest that in this subset of patients, cerclage would not be beneficial in preventing preterm delivery.