EP17.20: Amniocentesis and therapeutic amnioreduction prior to “Rescue Cerclage” (AARC Protocol)
Bibliographic record
Abstract
To determine whether amniotic fluid tests would identify patients who would benefit from rescue cerclage. This was a prospective observational study conducted between December 2021-2023. We included pregnancies involving singleton and twins, gestational age (GA) between 14-24 weeks, cervical dilation <4cm, with membranes at or beyond the external os and no labour signs. Risk of intra-amniotic inflammation or infection (IAI) was assessed using amniotic fluid white cell count, interleukin-6, glucose, gram-stain and culture. Amniocentesis to delivery interval (ADI) was the primary outcome. Secondary outcomes included GA at delivery and perinatal survival. A total of 26 patients were included, with five undelivered at abstract submission. The mean amniocentesis GA was 20.9 weeks. Nine patients (42.8%) had low-risk amniocentesis results, all of whom had rescue cerclage. The mean ADI among those with low-risk amniotic fluid tests was 78.8 days with mean GA at delivery of 32.8 weeks. Among this group, perinatal survival was 100%. Twelve patients (57.2%) had high-risk amniocentesis results, of which three patients had rescue cerclage. The mean ADI among those with high-risk amniotic fluid tests was 18.1 days with mean GA at delivery of 23.0 weeks. Among this group, perinatal survival was 41.7%. There were no survivors among those who underwent rescue cerclage, whose mean ADI was 22.7 days. Our AARC protocol identifies low-risk patients for IAI who would benefit from rescue cerclage.
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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 | 0.000 | 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 | 0.000 | 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".