Katharina, Putora; René, Hornung; Janis, Kinkel; Tina, Fischer; Putora, Paul Martin (2022). Progesterone, cervical cerclage or cervical pessary to prevent preterm birth: a decision-making analysis of international guidelines. BMC pregnancy and childbirth, 22(1), p. 355. BioMed Central 10.1186/s12884-022-04584-4
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OBJECTIVE
The aim of this study was to investigate guidelines on preterm birth, analyze decision-criteria, and to identify consensus and discrepancies among these guidelines.
DESIGN
Objective consensus analysis of guidelines.
SAMPLE
Ten international guidelines on preterm birth.
METHODS
Relevant decision criteria were singleton vs. twin pregnancy, history, cervical length, and cervical surgery / trauma or Mullerian anomaly. Eight treatment recommendations were extracted. For each decision-making criteria the most commonly recommended treatment was identified, and the level of consensus was evaluated.
MAIN OUTCOME MEASURES
Consensus and Discrepancies among recommendations.
RESULTS
In a case of singleton pregnancies with no history of preterm birth and shortened cervix, most guidelines recommend progesterone. In singleton pregnancies with a positive history and shortened cervix, all guidelines recommend a cerclage as an option, alternative or conjunct to progesterone. The majority of the guidelines advise against treatment in twin pregnancies.
CONCLUSIONS
A shortened cervix and a history of preterm birth are relevant in singleton pregnancies. In twins, most guidelines recommend no active treatment. Among international guidelines a shortened cervix and a history of preterm birth are relevant in singleton pregnancies. With no history of preterm birth and with a shortened cervix most guidelines recommend progesterone treatment.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology |
UniBE Contributor: |
Putora, Paul Martin |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1471-2393 |
Publisher: |
BioMed Central |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
26 Apr 2022 10:44 |
Last Modified: |
05 Dec 2022 16:19 |
Publisher DOI: |
10.1186/s12884-022-04584-4 |
PubMed ID: |
35461218 |
Uncontrolled Keywords: |
Cerclage Guidelines Pessary Preterm birth Progesterone |
BORIS DOI: |
10.48350/169526 |
URI: |
https://boris.unibe.ch/id/eprint/169526 |
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