ABOVE: Cerclage after Caesarean
Research type
Research Study
Full title
Cerclage after Caesarean: a randomised controlled trial to assess the optimal preventative management for preterm birth secondary to caesarean section damage (ABOVE)
IRAS ID
327879
Contact name
Andrew Shennan
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
2 years, 2 months, 30 days
Research summary
A third of all births are by caesarean section (CS), with half due to emergency procedures in labour. We have shown that women who have had an in-labour CS are at significantly increased risk of recurrent spontaneous preterm birth (sPTB) or a late miscarriage in future pregnancies (>50%).
This may occur because the incision made during in-labour CS can inadvertently be too low, damaging the cervix. Initial studies indicate that standard treatments (i.e. inserting a stitch vaginally in early pregnancy) for women at high risk of sPTBs are substantially less effective in these women. This could be because cervical damage is higher up than where the stitch is placed. As such we propose that stitches placed higher in the cervix via abdominal surgery (TAC) will be more effective.
This project will assess whether cervical stitches inserted using abdominal surgery are more effective than those inserted vaginally.
REC name
North West - Preston Research Ethics Committee
REC reference
24/NW/0093
Date of REC Opinion
7 May 2024
REC opinion
Further Information Favourable Opinion