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The World in Medicine
July 21, 2004

Reducing Preterm Delivery

JAMA. 2004;292(3):323. doi:10.1001/jama.292.3.323-d

Cervical cerclage, a common surgical procedure in use for the past 50 years, "does not substantially reduce the risk of early preterm delivery," according to a study by British researchers (Lancet. 2004;363:1849-1853). The treatment, which involves stitching the cervix to give it added strength, has been used in women assumed to be at higher risk of premature delivery by virtue of having a short cervix.

More than 47 000 women underwent an ultrasound examination to measure the cervix; 470 women were found to have cervixes short enough (≤15 mm) to put them at risk. The 253 who elected to participate in the multicenter study were randomly assigned to undergo the procedure or to "expectant management." About 22% of the women who were treated extended their pregnancy beyond 33 weeks, as did 26% of the control group.

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