Multifactorial Approach to Emergent Cerclage
| Status: | Completed |
|---|---|
| Conditions: | Women's Studies |
| Therapuetic Areas: | Reproductive |
| Healthy: | No |
| Age Range: | 18 - 80 |
| Updated: | 11/8/2014 |
| Start Date: | March 2010 |
| End Date: | July 2011 |
Role in Emergent Cerclage of Indomethacin and Antibiotics
Though cervical insufficiency is a common cause of second trimester pregnancy loss, the
placement of an emergent cerclage in these patients is thought to improve perinatal
outcomes. It is unknown whether the use of tocolytics and antibiotics prolongs pregnancies
complicated by need for emergent cerclage.
The objective is to determine whether administration of peri-operative antibiotics and
indomethacin to patients receiving emergent cerclages for cervical insufficiency increases
latency period to delivery compared with patients receiving emergent cerclage alone.
placement of an emergent cerclage in these patients is thought to improve perinatal
outcomes. It is unknown whether the use of tocolytics and antibiotics prolongs pregnancies
complicated by need for emergent cerclage.
The objective is to determine whether administration of peri-operative antibiotics and
indomethacin to patients receiving emergent cerclages for cervical insufficiency increases
latency period to delivery compared with patients receiving emergent cerclage alone.
Inclusion Criteria:
- GA 16+0 to 23+6 weeks
- Singleton gestation
- Presence of cervical dilation as diagnosed on digital examination
- Intact membranes
Exclusion Criteria:
- Age <18 years
- Allergy to NSAIDs
- Renal disease
- Allergy to penicillins AND clindamycin
- Currently on antibiotics or indomethacin for any reason
- HIV positive
- Pregnancies complicated by fetal congenital anomalies
- Preterm premature rupture of membranes
- Fever of 100.4 degrees Fahrenheit or higher
- Any patient having received a therapeutic cerclage during the current pregnancy
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