ArticleBMC pregnancy and childbirth2026
Physical examination-indicated repeat cerclage in singleton pregnancies: a retrospective cohort study.
Article in BMC pregnancy and childbirth, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
objectiveCervical insufficiency is a significant cause of mid-trimester miscarriage and preterm birth, for which cervical cerclage is the standard treatment. However, some patients experience extreme preterm delivery even after undergoing a repeat cerclage following initial cerclage failure. This study aimed to investigate the optimal timing for repeat cerclage and to identify independent predictors of its failure.
methodsThe sociodemographic characteristics and clinical data of 47 singleton pregnancies who underwent a repeat cerclage at Fujian Maternity and Child Health Hospital from October 2018 to May 2025 were retrospectively analyzed. Participants were divided into a failure group (delivery < 28 weeks, n = 17) and a success group (delivery ≥ 28 weeks, n = 30). Univariate and multivariate logistic regression analyses were used to identify independent risk factors. Receiver operating characteristic (ROC) curves were employed to determine optimal cut-off values for key continuous variables. Moreover, the BP neural network was used to perform a secondary validation of the independent risk factors.
resultsMultivariate analysis using Firth’s penalized logistic regression identified that cervical dilation before repeat cerclage (aOR = 3.098, 95% CI: 1.492–6.434, P = 0.002), elevated neutrophil-to-lymphocyte ratio (NLR) (aOR = 2.015, 95% CI: 1.055–3.849, P = 0.034), and positive cervical culture (aOR = 10.554, 95% CI: 2.506–44.442, P = 0.001) were independent risk factors for repeat cerclage failure. Exploratory ROC curve analysis suggested that preoperative cervical dilation ≥ 1.75 cm (AUC = 0.76) and NLR ≥ 4.9 (AUC = 0.83) may have predictive value for failure. A Back-Propagation (BP) neural network validation using Leave-One-Out Cross-Validation (LOOCV) achieved an accuracy of 74.5%, further confirming the predictive robustness of cervical dilation, NLR, and cervical culture.
conclusionPreoperative cervical dilation, systemic inflammation (NLR), and local cervical infection are key predictors of repeat cerclage failure. Our findings suggest that repeat cerclage may be most effective when cervical dilation is less than 2 cm and inflammatory markers are not elevated, though this requires prospective validation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.