Lack of Utility of Cerclage for Triplet Pregnancies with Asymptomatic Shortened Cervices

Service: Trial Number:
090-12
Principal Investigator: Conducted at:
Long Beach Memorial, Miller Children‘s Hospital Long Beach
Currently enrolling additional patients:
Yes

Triplet pregnancies represent a substantial burden on the healthcare system and obstetric providers in this country and locally. The overwhelming majority of triplet pregnancies are complicated by preterm birth and associated fetal/neonatal risks. As a consequence, the overwhelming majority of triplets require admissions to the neonatal intensive care unit (NICU) for management of conditions associated with prematurity and low birth weight. Cervical cerclage is one technique that can potentially prolong a pregnancy by sewing a cervix closed to ideally prevent preterm birth in women who have a shortened or dilated cervix but no signs of preterm labor. However, this procedure is not without risk to the patient and her fetuses. The objective of our study is to compare the outcomes of triplet pregnancies in women with asymptomatic cervical shortening with and without cervical cerclage. In particularly, we are looking to compare the neonatal outcomes amongst women treated with a cerclage against those who were not. Pregnant women will be identified by triplet gestations seen on ultrasound at either our Magella office at Long Beach Memorial Medical Center (LBMMC) or at Saddleback Memorial Medical Center (SMMC) between January 1998 and December 2004. All consecutive pregnancies complicated by triplet gestation with asymptomatic short cervix will be screened for the study. Fetal outcome data will be collected and analyzed from reviewing the maternal delivery records and the infant rounding notes and discharge summary. This is a resubmission of a previously approved IRB study (122-03) in order to obtain missing neonatal outcomes. The above years were selected as these were the years that were used during the original IRB approved study.

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