Impact of first-trimester mechanical cervical dilatation during curettage on maternal and neonatal outcomes: A retrospective comparative study
•Uterine evacuation is an important risk factor for PTD.•Mechanical cervical dilation performed during curettage does not increase the risk of preterm delivery.•Maternal and neonatal outcomes following mechanical cervical dilatation are similar to those without dilatation. Earlier studies have indic...
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| Veröffentlicht in: | European journal of obstetrics & gynecology and reproductive biology 2024-09, Vol.300, p.1-5 |
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| creator | Margaliot Kalifa, Tal Srebnik, Naama Sela, Hen Y. Armon, Shunit Grisaru-Granovsky, Sorina Rottenstreich, Misgav |
| description | •Uterine evacuation is an important risk factor for PTD.•Mechanical cervical dilation performed during curettage does not increase the risk of preterm delivery.•Maternal and neonatal outcomes following mechanical cervical dilatation are similar to those without dilatation.
Earlier studies have indicated a potential link between dilatation and curettage (D&C) and subsequent preterm delivery, possibly attributed to cervical damage. This study examines outcomes in pregnancies subsequent to first-trimester curettage with and without cervical dilatation.
A retrospective cohort study was conducted on women who conceived after undergoing curettage due to a first trimester pregnancy loss. Maternal and neonatal outcomes of the subsequent pregnancy were compared between two groups: women who underwent cervical dilatation before their curettage and those who had curettage without dilatation. The primary outcome assessed was the rate of preterm delivery at the subsequent pregnancy, and secondary outcomes included other adverse maternal and neonatal outcomes. Univariate analysis was performed, followed by multiple logistic regression models to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).
Among the 1087 women meeting the inclusion criteria during the study period, 852 (78.4 %) underwent first-trimester curettage with cervical dilatation, while 235 (21.6 %) opted for curettage only. No significant maternal or neonatal different outcomes were noted between the study groups, including preterm delivery (5.5 % vs. 3.5 %, p = 0.16), fertility treatments, placental complications, and mode of delivery. However, deliveries following D&C were associated with higher rates of small for gestational age neonates (7.6 % vs. 3.8 %, p = 0.04). Multivariate analysis revealed that cervical dilation before curettage was not significantly linked to preterm delivery [adjusted odds ratio 0.64 (0.33–1.26), p = 0.20].
The use of cervical dilatation during a curettage procedure for first trimester pregnancy loss, does not confer additional risk of preterm delivery. Further studies are needed to reinforce and validate these results. |
| doi_str_mv | 10.1016/j.ejogrb.2024.06.040 |
| format | Article |
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Earlier studies have indicated a potential link between dilatation and curettage (D&C) and subsequent preterm delivery, possibly attributed to cervical damage. This study examines outcomes in pregnancies subsequent to first-trimester curettage with and without cervical dilatation.
A retrospective cohort study was conducted on women who conceived after undergoing curettage due to a first trimester pregnancy loss. Maternal and neonatal outcomes of the subsequent pregnancy were compared between two groups: women who underwent cervical dilatation before their curettage and those who had curettage without dilatation. The primary outcome assessed was the rate of preterm delivery at the subsequent pregnancy, and secondary outcomes included other adverse maternal and neonatal outcomes. Univariate analysis was performed, followed by multiple logistic regression models to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).
Among the 1087 women meeting the inclusion criteria during the study period, 852 (78.4 %) underwent first-trimester curettage with cervical dilatation, while 235 (21.6 %) opted for curettage only. No significant maternal or neonatal different outcomes were noted between the study groups, including preterm delivery (5.5 % vs. 3.5 %, p = 0.16), fertility treatments, placental complications, and mode of delivery. However, deliveries following D&C were associated with higher rates of small for gestational age neonates (7.6 % vs. 3.8 %, p = 0.04). Multivariate analysis revealed that cervical dilation before curettage was not significantly linked to preterm delivery [adjusted odds ratio 0.64 (0.33–1.26), p = 0.20].
The use of cervical dilatation during a curettage procedure for first trimester pregnancy loss, does not confer additional risk of preterm delivery. Further studies are needed to reinforce and validate these results.</description><identifier>ISSN: 0301-2115</identifier><identifier>ISSN: 1872-7654</identifier><identifier>EISSN: 1872-7654</identifier><identifier>DOI: 10.1016/j.ejogrb.2024.06.040</identifier><identifier>PMID: 38972160</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Abortion, Spontaneous - epidemiology ; Abortion, Spontaneous - etiology ; Adult ; Cervical dilatation ; Curettage ; Dilatation and Curettage - adverse effects ; Dilatation and Curettage - statistics & numerical data ; Female ; Humans ; Infant, Newborn ; Miscarriage ; Pregnancy ; Pregnancy loss ; Pregnancy Outcome ; Pregnancy Trimester, First ; Premature Birth - epidemiology ; Premature Birth - etiology ; Preterm Delivery ; Retrospective Studies</subject><ispartof>European journal of obstetrics & gynecology and reproductive biology, 2024-09, Vol.300, p.1-5</ispartof><rights>2024 Elsevier B.V.</rights><rights>Copyright © 2024 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c311t-4978eab559e04deddc6d264b65641cb7eac4de78588d1b07986a3303e86956df3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0301211524003294$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38972160$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Margaliot Kalifa, Tal</creatorcontrib><creatorcontrib>Srebnik, Naama</creatorcontrib><creatorcontrib>Sela, Hen Y.</creatorcontrib><creatorcontrib>Armon, Shunit</creatorcontrib><creatorcontrib>Grisaru-Granovsky, Sorina</creatorcontrib><creatorcontrib>Rottenstreich, Misgav</creatorcontrib><title>Impact of first-trimester mechanical cervical dilatation during curettage on maternal and neonatal outcomes: A retrospective comparative study</title><title>European journal of obstetrics & gynecology and reproductive biology</title><addtitle>Eur J Obstet Gynecol Reprod Biol</addtitle><description>•Uterine evacuation is an important risk factor for PTD.•Mechanical cervical dilation performed during curettage does not increase the risk of preterm delivery.•Maternal and neonatal outcomes following mechanical cervical dilatation are similar to those without dilatation.
Earlier studies have indicated a potential link between dilatation and curettage (D&C) and subsequent preterm delivery, possibly attributed to cervical damage. This study examines outcomes in pregnancies subsequent to first-trimester curettage with and without cervical dilatation.
A retrospective cohort study was conducted on women who conceived after undergoing curettage due to a first trimester pregnancy loss. Maternal and neonatal outcomes of the subsequent pregnancy were compared between two groups: women who underwent cervical dilatation before their curettage and those who had curettage without dilatation. The primary outcome assessed was the rate of preterm delivery at the subsequent pregnancy, and secondary outcomes included other adverse maternal and neonatal outcomes. Univariate analysis was performed, followed by multiple logistic regression models to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).
Among the 1087 women meeting the inclusion criteria during the study period, 852 (78.4 %) underwent first-trimester curettage with cervical dilatation, while 235 (21.6 %) opted for curettage only. No significant maternal or neonatal different outcomes were noted between the study groups, including preterm delivery (5.5 % vs. 3.5 %, p = 0.16), fertility treatments, placental complications, and mode of delivery. However, deliveries following D&C were associated with higher rates of small for gestational age neonates (7.6 % vs. 3.8 %, p = 0.04). Multivariate analysis revealed that cervical dilation before curettage was not significantly linked to preterm delivery [adjusted odds ratio 0.64 (0.33–1.26), p = 0.20].
The use of cervical dilatation during a curettage procedure for first trimester pregnancy loss, does not confer additional risk of preterm delivery. Further studies are needed to reinforce and validate these results.</description><subject>Abortion, Spontaneous - epidemiology</subject><subject>Abortion, Spontaneous - etiology</subject><subject>Adult</subject><subject>Cervical dilatation</subject><subject>Curettage</subject><subject>Dilatation and Curettage - adverse effects</subject><subject>Dilatation and Curettage - statistics & numerical data</subject><subject>Female</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Miscarriage</subject><subject>Pregnancy</subject><subject>Pregnancy loss</subject><subject>Pregnancy Outcome</subject><subject>Pregnancy Trimester, First</subject><subject>Premature Birth - epidemiology</subject><subject>Premature Birth - etiology</subject><subject>Preterm Delivery</subject><subject>Retrospective Studies</subject><issn>0301-2115</issn><issn>1872-7654</issn><issn>1872-7654</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UU1P3DAUtCqqsmz7D1DlI5ekdpzYSQ9ICNGChNRLe7Yc-2XxKolT21mJP8Fv5sFSjvXFT6OZ9zFDyDlnJWdcftuXsA-72JcVq-qSyZLV7APZ8FZVhZJNfUI2TDBeVJw3p-QspT3DJ0T3iZyKtlMVl2xDnu6mxdhMw0AHH1MucvQTpAyRTmAfzOytGamFeHgtnB9NNtmHmbo1-nlH7RohZ7MDithkUDgjz8yOzhBmJI80rNkGbPqdXlEkx5AWsNkfgCK8mGhe65RX9_iZfBzMmODL278lf37c_L6-Le5__by7vrovrOA8F3WnWjB903TAagfOWekqWfeykTW3vQJjEVZt07aO90x1rTRCMAGt7BrpBrElF8e-Swx_V7xXTz5ZGEeDW69JC6akkoKjZkvqI9Xi4inCoBe0yMRHzZl-SULv9TEJ_ZKEZlJjEij7-jZh7Sdw76J_1iPh8kgAvPPgIepkPcwWnI9oj3bB_3_CMw6Zn5o</recordid><startdate>202409</startdate><enddate>202409</enddate><creator>Margaliot Kalifa, Tal</creator><creator>Srebnik, Naama</creator><creator>Sela, Hen Y.</creator><creator>Armon, Shunit</creator><creator>Grisaru-Granovsky, Sorina</creator><creator>Rottenstreich, Misgav</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202409</creationdate><title>Impact of first-trimester mechanical cervical dilatation during curettage on maternal and neonatal outcomes: A retrospective comparative study</title><author>Margaliot Kalifa, Tal ; Srebnik, Naama ; Sela, Hen Y. ; Armon, Shunit ; Grisaru-Granovsky, Sorina ; Rottenstreich, Misgav</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c311t-4978eab559e04deddc6d264b65641cb7eac4de78588d1b07986a3303e86956df3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abortion, Spontaneous - epidemiology</topic><topic>Abortion, Spontaneous - etiology</topic><topic>Adult</topic><topic>Cervical dilatation</topic><topic>Curettage</topic><topic>Dilatation and Curettage - adverse effects</topic><topic>Dilatation and Curettage - statistics & numerical data</topic><topic>Female</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Miscarriage</topic><topic>Pregnancy</topic><topic>Pregnancy loss</topic><topic>Pregnancy Outcome</topic><topic>Pregnancy Trimester, First</topic><topic>Premature Birth - epidemiology</topic><topic>Premature Birth - etiology</topic><topic>Preterm Delivery</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Margaliot Kalifa, Tal</creatorcontrib><creatorcontrib>Srebnik, Naama</creatorcontrib><creatorcontrib>Sela, Hen Y.</creatorcontrib><creatorcontrib>Armon, Shunit</creatorcontrib><creatorcontrib>Grisaru-Granovsky, Sorina</creatorcontrib><creatorcontrib>Rottenstreich, Misgav</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of obstetrics & gynecology and reproductive biology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Margaliot Kalifa, Tal</au><au>Srebnik, Naama</au><au>Sela, Hen Y.</au><au>Armon, Shunit</au><au>Grisaru-Granovsky, Sorina</au><au>Rottenstreich, Misgav</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of first-trimester mechanical cervical dilatation during curettage on maternal and neonatal outcomes: A retrospective comparative study</atitle><jtitle>European journal of obstetrics & gynecology and reproductive biology</jtitle><addtitle>Eur J Obstet Gynecol Reprod Biol</addtitle><date>2024-09</date><risdate>2024</risdate><volume>300</volume><spage>1</spage><epage>5</epage><pages>1-5</pages><issn>0301-2115</issn><issn>1872-7654</issn><eissn>1872-7654</eissn><abstract>•Uterine evacuation is an important risk factor for PTD.•Mechanical cervical dilation performed during curettage does not increase the risk of preterm delivery.•Maternal and neonatal outcomes following mechanical cervical dilatation are similar to those without dilatation.
Earlier studies have indicated a potential link between dilatation and curettage (D&C) and subsequent preterm delivery, possibly attributed to cervical damage. This study examines outcomes in pregnancies subsequent to first-trimester curettage with and without cervical dilatation.
A retrospective cohort study was conducted on women who conceived after undergoing curettage due to a first trimester pregnancy loss. Maternal and neonatal outcomes of the subsequent pregnancy were compared between two groups: women who underwent cervical dilatation before their curettage and those who had curettage without dilatation. The primary outcome assessed was the rate of preterm delivery at the subsequent pregnancy, and secondary outcomes included other adverse maternal and neonatal outcomes. Univariate analysis was performed, followed by multiple logistic regression models to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).
Among the 1087 women meeting the inclusion criteria during the study period, 852 (78.4 %) underwent first-trimester curettage with cervical dilatation, while 235 (21.6 %) opted for curettage only. No significant maternal or neonatal different outcomes were noted between the study groups, including preterm delivery (5.5 % vs. 3.5 %, p = 0.16), fertility treatments, placental complications, and mode of delivery. However, deliveries following D&C were associated with higher rates of small for gestational age neonates (7.6 % vs. 3.8 %, p = 0.04). Multivariate analysis revealed that cervical dilation before curettage was not significantly linked to preterm delivery [adjusted odds ratio 0.64 (0.33–1.26), p = 0.20].
The use of cervical dilatation during a curettage procedure for first trimester pregnancy loss, does not confer additional risk of preterm delivery. Further studies are needed to reinforce and validate these results.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>38972160</pmid><doi>10.1016/j.ejogrb.2024.06.040</doi><tpages>5</tpages></addata></record> |
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| subjects | Abortion, Spontaneous - epidemiology Abortion, Spontaneous - etiology Adult Cervical dilatation Curettage Dilatation and Curettage - adverse effects Dilatation and Curettage - statistics & numerical data Female Humans Infant, Newborn Miscarriage Pregnancy Pregnancy loss Pregnancy Outcome Pregnancy Trimester, First Premature Birth - epidemiology Premature Birth - etiology Preterm Delivery Retrospective Studies |
| title | Impact of first-trimester mechanical cervical dilatation during curettage on maternal and neonatal outcomes: A retrospective comparative study |
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