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 distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.077 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".