• Yijun Liu, Meng Chen, Tiantian Cao, Shuai Zeng, Ruixin Chen, and Xinghui Liu.
• West China Second Hospital, Sichuan University, Department of Gynecology and Obstetrics, Chengdu, 610041, China.
• Eur. J. Obstet. Gynecol. Reprod. Biol. 2021 May 1; 260: 137-149.

ObjectiveData on the prevention of preterm birth in twin pregnancies with cervical cerclage remain inconsistent. Thus, this study aimed to comprehensively evaluate the value of cervical cerclage as a treatment strategy to prevent preterm birth in twin pregnancies with regard to both maternal and neonatal outcomes.Study DesignIn this systematic review and meta-analysis, the PubMed, Cochrane Library, Medline, EMBASE, and Web of Science databases were searched for relevant studies and trials from their inception up to December 2020. Outcomes were expressed as risk ratios and standardized mean differences in a meta-analysis model using STATA 15.0 software.ResultsThe search included 944 studies, 15 of which were eligible for inclusion, representing 726 patients treated with cervical cerclage and 8578 non-cerclage treatment controls. When the cervical length was <15 mm, the risk ratio of preterm birth at <37 weeks (0.77, p = 0.01), <34 weeks (0.58, p = 0.002), and <32 weeks (0.61, p = 0.024) of gestation in the cerclage group was significantly lower than that in the non-cerclage group.ConclusionFor twin pregnancies with a cervical length <15 mm, cervical cerclage was associated with significant reduction in preterm birth.Copyright © 2021 Elsevier B.V. All rights reserved.

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