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Volume 11 (2011), Pages 1660-1666
Research Article

Viable Extreme Preterm Birth and Some Neonatal Outcomes in Double Cerclage versus Traditional Cerclage: A Randomized Clinical Trial

1Obstetrics and Gynecology Department, Urmia University of Medical Sciences, Urmia 57146-15463, Iran
2Shahid Motahhari University Hospital, Kashani Street, Urmia 57146-15463, Iran
3Department of Epidemiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia 57146-15463, Iran

Received 23 June 2011; Revised 7 August 2011; Accepted 8 August 2011

Academic Editor: Hatim Omar

Copyright © 2011 Farzaneh Broumand et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The pregnant women at higher risk of preterm labor, referred to the perinatal clinic of Kosar University Hospital in Urmia district of Iran, were enrolled into a parallel randomized clinical trial. In the investigational arm of the clinical trial, a double cervical cerclage procedure was performed addition to McDonald cerclage. In the control group however, only McDonald cerclage was performed. Extreme preterm labor (GA < 33 weeks) was the primary endpoint of this clinical trial. Age, gestational age at cerclage time, and gravidity were not found to be statistically different between the groups. Means of gestational age were 37.4 and 36.2 weeks, respectively, for the investigational and control groups. The gestational age was 1.2 weeks longer for double cerclage group but the difference was not found to be statistically significant. Preterm birth before 33 weeks of gestation was not experienced by any of the patients who received double cerclage, but five women in control group developed such an extreme preterm labor ( 𝑃 < 0 . 0 5 ). The absolute risk reduction in using double cerclage over traditional method was 18 percent (95% confidence interval, 4%–32%). Double cerclage appeared to have higher efficacy than traditional cerclage in preventing preterm labor <33 weeks of gestation.