Comment: The quality of evidence is downgraded by study limitations (unclear allocation concealment in half of the studies and unclear blinding of outcome assessment) and by imprecise results (wide confidence intervals).
A Cochrane review [Abstract] 1 included 5 studies with a total of 128 subjects, of which 122 women had twin gestations, and six women had triplet gestations. Two trials (n = 73 women) assessed history-indicated cerclage, while three trials (n = 55 women) assessed ultrasound-indicated cerclage. Compared with no cerclage, there was no statistically significant differences in perinatal deaths (19.2% vs 9.5%; RR 1.74, 95% CI 0.92 to 3.28; 5 trials, n=262), serious neonatal morbidity (15.8% vs 13.6%; average RR 0.96, 95% CI 0.13 to 7.10; 3 trials, n = 116), or composite perinatal death and neonatal morbidity (40.4% vs 20.3%; average RR 1.54, 95% CI 0.58 to 4.11; 3 trials, n = 116).There were no significant differences among the following: preterm birth less than 34 weeks (average RR 1.16, 95% CI 0.44 to 3.06; 4 trials, n = 83), low birthweight less than 2500 g (average RR 1.10, 95% CI 0.82 to 1.48; 4 trials, n = 172), respiratory distress syndrome (average RR 1.70, 95% CI 0.15 to 18.77; 3 trials, n = 116), and caesarean section (elective and emergency) (RR 1.24, 95% CI 0.65 to 2.35; 3 trials, n = 77).No trials reported on long-term infant neurodevelopmental outcomes.
Date of latest search:30 June 2014
Primary/Secondary Keywords