Comparative analysis of pregnancy outcomes after emergency and elective cerclage: A systematic review and meta-analysis
Bibliographic record
Abstract
Cervical insufficiency poses significant risks to ongoing pregnancies, often necessitating interventions such as cervical cerclage. This review compares pregnancy outcomes in women who underwent emergency or elective cerclage. A comprehensive literature search of PubMed, Scopus, Embase, Cochrane library and Web of Science databases was conducted from the inception of these databases up to 30 April 2024. The risk of bias was assessed using the Newcastle Ottawa scale (NOS). Odds ratios (OR) and weighted mean differences (WMD) were calculated depending on the type of outcome using random-effects model. Overall, 27 studies were included. Gestational age of women who underwent emergency cerclage was significantly higher at cerclage (WMD of 6.500 and 5.698 weeks for physical examination-guided and ultrasound-guided cerclage, respectively, compared to elective cerclage). Emergency cerclage placement was associated with lower neonatal birth weights, particularly in the physical examination-guided group (WMD = -780.52 grams). The risk of PROM was higher in the physical examination-guided emergency cerclage group (OR = 2.197). However, the incidence of PROM was comparable in the elective and ultrasound-guided groups. Physical examination-guided cerclage was associated with significantly higher vaginal delivery rates compared to the emergency cerclage (OR = 1.750). Emergency cerclage, especially when guided by physical examination, is associated with later gestation at application and higher risks of adverse neonatal outcomes compared to elective cerclage. Registration: PROSPERO: CRD42024546566.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.014 | 0.004 |
| Bibliometrics | 0.001 | 0.005 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".