Observational studyScientific reports2025
Effect of cervical cerclage on uterine artery doppler parameters and small for gestational age births.
Observational study in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
To evaluate the effect of vaginal cervical cerclage on uterine artery Doppler parameters and its association with small for gestational age births across different clinical indications. This prospective observational study included 140 singleton pregnancies undergoing cervical cerclage, stratified by indication: prophylactic (n = 39), ultrasound-based (n = 62), and rescue cerclage (n = 39). Uterine artery pulsatility index was measured preoperatively, postoperatively, and at six weeks post-procedure. Fetal growth parameters were monitored throughout pregnancy, with births below the 10th percentile classified as small for gestational age. All procedures utilized McDonald's technique at a single tertiary center. Postoperative pulsatility index increased significantly in the prophylactic cerclage group (p < 0.001), but showed minimal change in the ultrasound-based and rescue groups. PI values normalized in all groups by six weeks. Small for gestational age births occurred in 7.9% overall (prophylactic 12.8%, ultrasound-based 4.8%, rescue 7.7%), with no significant difference (p = 0.410). Postoperative pulsatility index values above the 95th percentile were significantly more common in the prophylactic group (30.8%) than in ultrasound-based (6.5%) or rescue cerclage groups (2.6%) (p < 0.001). Cervical cerclage may cause early, transient uterine hemodynamic changes, particularly in women undergoing prophylactic cerclage for a history of painless mid-trimester loss. These changes typically resolve within six weeks and are not associated with adverse fetal growth outcomes, supporting an adaptive rather than pathological response. In clinical practice, transient postoperative Doppler elevations should be interpreted in light of indication and timing rather than regarded as alarming. These findings provide reassurance for clinical counseling on cerclage safety and emphasize the importance of indication-specific Doppler monitoring to guide follow-up and patient management.
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