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Saturday, May 10, 2014
Trailers (82): Indomethacin and antibiotics for examination-indicated cerclage

Miller et al. Indomethacin and antibiotics in examination-indicated cerclage: a randomized controlled trial

Why should you read about this topic?

Whatever can be done to increase the length of quality intrauterine time is likely to reap neonatal benefits.

What were the authors trying to do?

Evaluate whether perioperative indomethacin and antibiotics prolong gestation after examination-indicated cerclage.

Who participated and in what setting?

Women (N=53) 16-24 weeks undergoing an examination-indicated cerclage between 2010 and 2012

What was the study design?

Randomized controlled trial of postoperative indomethacin and perioperative antibiotics compared with no medications

What were the main outcome measures?

Gestational latency after cerclage

What were the results?

More pregnancies were prolonged at least 28 days in the treatment group (92%) than in the control group (63%).  However, median gestational latency, gestational age at delivery and neonatal outcomes were not different between groups.

What is the most interesting image in the paper?

Figure 2

What were the study strengths and weaknesses?

Strengths: randomized controlled trial; pre-specified secondary outcomes analysis.    Weaknesses: underpowered for meaningful clinical differences.

What does the study contribute for your practice?

Still don’t know if perioperative antibiotics and NSAIDs are beneficial for examination-indicated cerclage

About the Author

William C. Dodson, MD
William C. Dodson, MD, is Professor of Obstetrics and Gynecology and Director of the Division of Reproductive Endocrinology and Infertility at Penn State College of Medicine. He completed his fellowship in reproductive endocrinology at Duke University. His research and clinical areas of focus include treatment of infertility, especially ovulation induction. He was previously on the Editorial Board of Obstetrics & Gynecology and has served as the Consultant Web Editor for Obstetrics & Gynecology since 2008.