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. 2017 Jun 6;2017(6):CD008991. doi: 10.1002/14651858.CD008991.pub3

Comparison 5. Any comparison of different cerclage protocols.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1 All perinatal losses 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
1.1 History‐indicated cerclage vs ultrasound‐indicated cerclage 1 247 Risk Ratio (M‐H, Fixed, 95% CI) 1.37 [0.63, 2.96]
2 Serious neonatal morbidity 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
2.1 History‐indicated cerclage vs ultrasound‐indicated cerclage 1 247 Risk Ratio (M‐H, Fixed, 95% CI) 1.71 [0.51, 5.69]
3 Baby discharged home healthy 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
3.1 History‐indicated cerclage vs ultrasound‐indicated cerclage 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
3.2 History‐indicated cerclage vs physical exam‐indicated cerclage 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
4 Stillbirths 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
4.1 History‐indicated cerclage vs ultrasound‐indicated cerclage 1 247 Risk Ratio (M‐H, Fixed, 95% CI) 0.49 [0.04, 5.31]
5 Neonatal deaths before discharge 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
5.1 History‐indicated cerclage vs ultrasound‐indicated cerclage 1 247 Risk Ratio (M‐H, Fixed, 95% CI) 0.24 [0.03, 2.15]
5.2 History‐indicated cerclage vs physical exam‐indicated cerclage 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
6 Miscarriages 2 344 Risk Ratio (M‐H, Random, 95% CI) 1.71 [0.55, 5.30]
6.1 History‐indicated cerclage vs ultrasound‐indicated cerclage 2 344 Risk Ratio (M‐H, Random, 95% CI) 1.71 [0.55, 5.30]
7 Preterm birth before 37 completed weeks 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
7.1 History‐indicated cerclage vs ultrasound‐indicated cerclage 1 97 Risk Ratio (M‐H, Fixed, 95% CI) 0.72 [0.25, 2.05]
8 Preterm birth before 34 completed weeks 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
8.1 History‐indicated cerclage vs ultrasound‐indicated cerclage 1 247 Risk Ratio (M‐H, Fixed, 95% CI) 1.03 [0.57, 1.87]
9 Preterm birth before 28 completed weeks 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
9.1 History‐indicated cerclage vs ultrasound‐indicated cerclage 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
9.2 History‐indicated cerclage vs physical exam‐indicated cerclage 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
10 Serious intracranial pathology (IVH or periventricular leucomalacia) 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
10.1 History‐indicated cerclage vs ultrasound‐indicated cerclage 1 247 Risk Ratio (M‐H, Fixed, 95% CI) 1.95 [0.36, 10.46]
10.2 History‐indicated cerclage vs physical exam‐indicated cerclage 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
11 Serious respiratory morbidity (RDS or oxygen dependency after 28 days of life) 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
11.1 History‐indicated cerclage vs ultrasound‐indicated cerclage 1 247 Risk Ratio (M‐H, Fixed, 95% CI) 1.46 [0.25, 8.61]
11.2 History‐indicated cerclage vs physical exam‐indicated cerclage 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
12 Necrotising enterocolitis 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
12.1 History‐indicated cerclage vs ultrasound‐indicated cerclage 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
12.2 History‐indicated cerclage vs physical exam‐indicated cerclage 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
13 Retinopathy of prematurity 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
13.1 History‐indicated cerclage vs ultrasound‐indicated cerclage 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
13.2 History‐indicated cerclage vs physical exam‐indicated cerclage 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
14 Apgar < 7 at 5 minutes 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
14.1 History‐indicated cerclage vs ultrasound‐indicated cerclage 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
14.2 History‐indicated cerclage vs physical exam‐indicated cerclage 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
15 Caesarean section (elective and emergency) 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
15.1 History‐indicated cerclage vs ultrasound‐indicated cerclage 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
15.2 History‐indicated cerclage vs physical exam‐indicated cerclage 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
16 Maternal infection requiring intervention(antibiotics or delivery) 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
16.1 History‐indicated cerclage vs ultrasound‐indicated cerclage 1 247 Risk Ratio (M‐H, Fixed, 95% CI) 0.33 [0.01, 7.91]
16.2 History‐indicated cerclage vs physical exam‐indicated cerclage 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
17 Maternal side effects (vaginal discharge, bleeding, pyrexia not requiring antibiotics) 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
17.1 History‐indicated cerclage vs ultrasound‐indicated cerclage 1 243 Risk Ratio (M‐H, Fixed, 95% CI) 0.54 [0.21, 1.42]
17.2 History‐indicated cerclage vs physical exam‐indicated cerclage 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
18 Tocolysis (not prespecified) 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
18.1 History‐indicated cerclage vs ultrasound‐indicated cerclage 1 247 Risk Ratio (M‐H, Fixed, 95% CI) 0.44 [0.16, 1.24]