Evidence map›Paper›PMID 32886234›Full record

ArticleArchives of gynecology and obstetrics2021

Physical examination-indicated cerclage in twin pregnancy: a retrospective cohort study.

Mian Pan, Jun Zhang, Wenqiang Zhan, Xia Ouyang, Xiaoxiang Jiang, Danlin Yang

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Article in Archives of gynecology and obstetrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Mian PanDepartment of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350108, Fujian, China.
Jun ZhangDepartment of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350108, Fujian, China. 175695401@qq.com.ORCID http://orcid.org/0000-0003-1509-9499
Wenqiang ZhanSchool of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.
Xia OuyangDepartment of Neonatology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350108, Fujian, China.
Xiaoxiang JiangDepartment of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350108, Fujian, China.
Danlin YangDepartment of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350108, Fujian, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aimed to evaluate the efficacy of physical examination-indicated cerclage in twin pregnancies and compare it with those that received conservative management.

methodsWe used a retrospective cohort study design of asymptomatic twin pregnancies identified with physical examination indications at 14-26 weeks from 2015 through 2019 at Fujian Maternity and Child Health Hospital. The primary outcomes were gestational age (GA) at delivery and the incidence of spontaneous preterm birth (SPTB) at < 34 weeks, < 32 weeks, < 28 weeks, and < 24 weeks. The main secondary outcomes were latency period from diagnosis to delivery, composite neonatal adverse outcome and neonatal survival at discharge.

resultsThirty-one women with twin pregnancies were managed with physical examination-indicated cerclage, and another 31 received expectant management. The demographic characteristics of the two groups were not significantly different. GA at delivery was significantly later in the cerclage group than in the controls: 32.53 ± 4.78 vs. 27.53 ± 4.15 weeks, with a mean difference of 5.00 weeks [95% confidence interval (CI), 2.73-7.28]. There were significant decreases in the incidence of spontaneous preterm birth (SPTB) at < 34 weeks, < 32 weeks, < 28 weeks, and < 24 weeks in the cerclage group. The interval from diagnosis to delivery was increased with cerclage by a mean difference of 4.37 weeks (95% CI, 1.96-7.06). Regarding neonatal outcome, the perinatal mortality rate in the cerclage group was significantly reduced compared to that in the control group [8/62 (12.9%) vs. 26/62 (41.9%); P < 0001]. Likewise, the neonatal intensive care unit (NICU) admissions, length of stay in the NICU, and composite adverse neonatal outcome in the cerclage group were significantly reduced.

conclusionPhysical examination-indicated cerclage was associated with significantly later GA at delivery, longer latency period from diagnosis to delivery, decreased incidence of SPTB at any given GA, and improved perinatal outcome compared with the corresponding measures in controls treated conservatively.

Indexed as

Gynecological ExaminationAdultCerclage, CervicalFemaleGestational AgeHumansInfantInfant, NewbornIntensive Care Units, NeonatalPerinatal MortalityPhysical ExaminationPregnancyPregnancy OutcomePregnancy, TwinPremature BirthRetrospective StudiesCervical cerclageCervical lengthDilated cervixPhysical examination indicationPreterm birthTwin pregnancy

Identifiers

PMID32886234

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.