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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Milner, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, Marc J.N.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland

9 Issues per year


IMPACT FACTOR 2016: 1.577
5-year IMPACT FACTOR: 1.705

CiteScore 2016: 1.49

SCImago Journal Rank (SJR) 2016: 0.602
Source Normalized Impact per Paper (SNIP) 2016: 0.832

Online
ISSN
1619-3997
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Volume 36, Issue 6 (Nov 2008)

Issues

History-indicated cerclage: practice patterns of maternal-fetal medicine specialists in the USA

Nathan S. Fox
  • 1Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA
/ Shari E. Gelber
  • 2Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA
/ Robin B. Kalish
  • 3Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA
/ Stephen T. Chasen
  • 4Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA
Published Online: 2008-07-24 | DOI: https://doi.org/10.1515/JPM.2008.083

Abstract

Objective: There is limited evidence supporting the effectiveness of history-indicated cerclage in preventing spontaneous pregnancy loss or preterm birth. This study was undertaken to estimate the practice patterns of maternal-fetal medicine specialists in regards to history-indicated cerclage.

Methods: We performed a mail-based survey of all SMFM specialists in the US. Subjects were asked whether they would recommend a history-indicated cerclage at 12–14 weeks in a patient whose prior pregnancy was her first pregnancy and ended in a spontaneous, painless loss at 19 weeks with no identifiable cause.

Results: A total of 827 (46%) of SMFM members responded of which 75% would recommend a history-indicated cerclage for this patient. Twenty-one percent would not recommend one, but would place one if desired by the patient. Only 4% would not place a history-indicated cerclage in this scenario. A total of 71% believed a history-indicated cerclage was associated with moderate or significant benefit, and 89% believed it involved minimal or no risk. Female gender, non-academic practice, practicing in the southern region and greater interval since residency training were all independently associated with the recommendation for a history-indicated cerclage.

Conclusions: Despite limited level-I evidence supporting its use, a history-indicated cerclage is recommended by most maternal-fetal medicine specialists.

Keywords: Cerclage; history-indicated; prophylactic; second trimester loss; SMFM

About the article

Corresponding author: Nathan S. Fox, MD Maternal Fetal Medicine Associates PLLC 70 East 90th Street New York, NY 10128 USA Tel.: 1-212-722-7409 Fax: 1-212-722-7185


Received: 2008-03-29

Revised: 2008-04-14

Accepted: 2008-04-21

Published Online: 2008-07-24

Published Online: 2008-07-24

Published in Print: 2008-11-01


Citation Information: Journal of Perinatal Medicine, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/JPM.2008.083.

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