Evidence map›Paper›PMID 40631398›Full record

ArticleUltrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology2025

Predictive value of cervical length for spontaneous preterm birth in women with cervical cerclage.

K E Mountain, S Ng, T Elger, H Judah, R Akolekar, H V Lewis, D A MacIntyre, V Terzidou, P R Bennett, T G Teoh and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
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

12 authors.

K E Mountain *March of Dimes Prematurity Research Centre at The Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
S Ng *March of Dimes Prematurity Research Centre at The Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
T ElgerKing's College Hospital NHS Foundation Trust, London, UK.ORCID 0000-0002-6503-5840
H JudahKing's College Hospital NHS Foundation Trust, London, UK.
R AkolekarMedway NHS Foundation Trust, Gillingham, UK.ORCID 0000-0001-7265-5442
H V LewisMarch of Dimes Prematurity Research Centre at The Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
D A MacIntyreMarch of Dimes Prematurity Research Centre at The Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
V TerzidouMarch of Dimes Prematurity Research Centre at The Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
P R BennettMarch of Dimes Prematurity Research Centre at The Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
T G TeohMarch of Dimes Prematurity Research Centre at The Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
L SykesMarch of Dimes Prematurity Research Centre at The Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.ORCID 0000-0002-7806-5707
K H NicolaidesKing's College Hospital NHS Foundation Trust, London, UK.ORCID 0000-0003-1266-0711

Funding

NIHR Imperial Biomedical Research CentreThe March of DimesThe Parasol Foundation Centre for Women's Health and Cancer ResearchTommy's Charity
6 · The paper itself

Abstract

objectiveCervical cerclage is an important treatment used to prevent spontaneous preterm birth (sPTB), but it is not universally successful. Understanding the factors associated with cerclage treatment failure may lead to improved patient selection and better patient outcomes. The objective of this study was to investigate the value of pre- and post-cerclage cervical length (CL) in predicting sPTB < 34 weeks.

methodsThis was a retrospective cohort study conducted in four preterm birth prevention clinics in the UK. We included 331 women who had undergone cervical cerclage between January 2008 and March 2021, and analyzed their pre- and post-cerclage CL, as measured by transvaginal ultrasound scan. The primary outcome was sPTB < 34 weeks' gestation, assessed using multivariable logistic regression modeling (variables were pre- and post-cerclage CL, gestational age at cerclage and direction of CL change) and the generation of receiver-operating-characteristic (ROC) curves. Differences in sPTB for underlying risk factors (race, smoking history, previous cervical surgery or pregnancy history risk factors, including mid-trimester loss or sPTB) were assessed using Fisher's exact test.

resultsBoth pre- and post-cerclage CL were independently discriminative of sPTB < 34 weeks' gestation, with areas under the ROC curve of 0.635 (95% CI, 0.559-0.712) and 0.677 (95% CI, 0.604-0.751), respectively, and were modest contributors to sPTB prediction based on multivariable logistic regression modeling (odds ratio (OR), 0.964 (95% CI, 0.936-0.994), P = 0.018 and 0.940 (95% CI, 0.910-0.970), P < 0.001, respectively). There were no significant differences in the rate of sPTB < 34 weeks' gestation according to race, smoking history, previous cervical surgery or pregnancy history risk factors, including previous mid-trimester loss or sPTB.

conclusionsPost-cerclage CL is the predominant predictor of sPTB < 34 weeks' gestation. Underlying sPTB risk factors (previous cervical surgery and pregnancy history) may influence pre-cerclage CL and the direction of CL change following cerclage, but once these are adjusted for, they do not influence the risk of sPTB < 34 weeks' gestation. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Indexed as

Cerclage, CervicalCervical Length MeasurementCervix UteriPremature BirthAdultFemaleGestational AgeHumansPredictive Value of TestsPregnancyRetrospective StudiesRisk FactorsROC CurveUnited KingdomUterine Cervical Incompetencecervical cerclagecervical lengthperinatologyspontaneous preterm birth

Identifiers

PMID40631398
PMCPMC12317304

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.