P01.04: Emergency cerclage: evaluation of its efficacy and identification of prognostic factors
Bibliographic record
Abstract
To evaluate the efficacy of emergency cerclage and identify clinical variables that may have an impact on pregnancy outcome. Retrospective study (2003–2013) of women with singleton pregnancies who underwent emergency cervical cerclage between 15 and 24 weeks of gestation. An emergency cerclage was defined as a cerclage placement in women with a cervical length of less than 15 mm and/or cervical dilation greater than or equal to 1 cm at time of procedure. Subjects were divided into groups depending on gestational age at delivery for comparison of variables. 88 women were identified and 2 were excluded from statistical analysis due to amniotic membrane rupture at the time of cerclage. The mean gestational age at the time of cerclage was 20.5 weeks. The mean cerclage-delivery interval was 72 days. The mean gestation at delivery was 31 weeks. 76 percent of women delivered after 24 weeks, 65% delivered after 28 weeks and 49% delivered after 34 weeks. The mean cervical length at time of cerclage was 7.5 mm and the mean cervical dilation was 1.7 cm. A cervical length < 5 mm prior to the cerclage predicted a delivery before 34 weeks (p = 0.001) whereas a cervical length < 10 or even 15 mm did not predict delivery before 34 weeks. An ultrasound indicated cerclage defined as women with no cervical dilation at time of cerclage predicted delivery after 34 weeks (p = 0.001). The prolapse of amniotic membranes in the vagina predicted a delivery before 28 weeks gestation whereas prolapse at the cervical os predicted a delivery before 34 weeks (p = 0.001). The presence of sludge did not predict preterm delivery. It is known that emergency cerclage can prolong pregnancy and delay delivery in women presenting cervical incompetence. In the last ten years, we have identified 88 emergency cerclage in our centre and the average time gained after an emergency cerclage was 10 weeks. Some variables were associated with a shorter cerclage-delivery interval such as amniotic membranes prolapse, cervical dilatation > 2 cm and cervical length < 5 mm.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".