Poster Session 3
Category: Medical/Surgical/Diseases/Complications
Poster Session 3
.jpg "Shir Zagdon Keidar, MD (she/her/hers) photo")
Shir Zagdon Keidar, MD (she/her/hers)
Resident in Obstetrics and Gynecology
Soroka University Medical Center, Ben-Gurion University of the Negev
Beer sheva, HaDarom, Israel
Hilit Annie Zucker, N/A
student
Soroka University Medical Center, Ben-Gurion University of the Negev
Beer sheva, HaDarom, Israel
Lior Yahav, MD, MPH
Maternal-Fetal Medicine specialist
Soroka University Medical Center, Ben-Gurion University of the Negev
beer-sheva, HaDarom, Israel
Tali Silberstein, MD
Professor of Obstetrics and Gynecology; Director of Women’s Day Surgery & Operating Rooms Unit
Soroka University Medical Center, Faculty of Health Sciences, Ben‑Gurion University of the Negev
Beer sheva, HaDarom, Israel
Maya Maimon Solomom, MD
OB/GYN Resident
Soroka University Medical Center, Ben-Gurion University of the Negev
Beer sheva, HaDarom, Israel
Tamar Eshkoli, MD
Senior
Soroka Medical Center, Ben Gurion University of the Negev
beer sheba, HaDarom, Israel
Adi Y. Weintraub, MD
Professor of Obstetrics & Gynecology; Urogynecology & Pelvic Floor Medicine Specialist
Soroka University Medical Center, Faculty of Health Sciences, Ben‑Gurion University of the Negev
beer sheba, HaDarom, Israel
To assess whether systemic inflammatory markers -specifically the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and related indices-can predict the success of emergency cervical cerclage (ECC) in women with cervical insufficiency diagnosed in the second trimester.
Study Design:
This retrospective cohort study included 53 women who underwent ECC between 17 and 24 weeks of gestation at a tertiary academic hospital between the years 2015 and 2024. The primary outcome was cerclage efficacy, defined as a prolongation of pregnancy by ≥4 weeks. Demographic, obstetric, and laboratory data-including NLR, PLR, the systemic immune-inflammation index (SII), the systemic inflammation response index (SIRI), and the aggregate index of systemic inflammation (AISI), were compared between the effective cerclage and failed cerclage groups.
Results:
Among the 53 patients, 44 (83%) had a pregnancy prolongation by ≥4 weeks. No significant differences were observed between groups in maternal age, BMI, comorbidities, IVF rates, or hemoglobin levels. The presence of bulging membranes (77.8% vs. 13.6%, p< 0.001) and cervical dilation at presentation (77.8% vs. 31.8%, p=0.02) were significantly associated with cerclage failure. However, none of the inflammatory markers demonstrated a statistically significant association with cerclage outcomes. NLR was similar between groups (4.51 ± 2.28 vs. 4.57 ± 2.61, p=0.94). PLR, SII, SIRI, and AISI also failed to distinguish between effective and failed cerclage.
Conclusion:
Despite a well-established association between inflammation and obstetric complications such as spontaneous preterm birth, second-trimester pregnancy loss, and cervical shortening, this study found that commonly used systemic inflammatory markers do not predict ECC effectiveness. These findings highlight the limitations of currently available noninvasive biomarkers in guiding clinical decisions regarding rescue cerclage.