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KCE reports vol. 6A Prenatale zorg 64
6. Pelvic/cervical examination
What is the efficacy of routine cervical examination in identifying women at risk of preterm delivery and what are the secondary effects?
Study Ref Population Intervention Outcomes Results Comments Study
Buekens
et al.,
1994
4 [542] 5440 women from antenatal
clinics in Belgium, Denmark,
Hungary, Ireland, Italy,
Portugal and Spain from
1988 to 1990
Routine cervical examination at every
antenatal appointment (n=2719) vs.
avoidance of cervical examination if
possible (n=2721)
Median number of
examinations
Preterm birth (<
37 weeks)
Low birth weight
(< 2500g)
Premature rupture
of the membranes
(PROM)
Stillbirth
6 in the experimental
and 1 in the control
group
Preterm birth: 5.7%
vs. 6.4%, RR 0.88, 95%
CI 0.72 to 1.09
PROM: 27.1 vs. 26.5%,
RR 1.02, 95% CI 0.94
to 1.12
Stillbirth: 8.7% vs.
8.0%, RR 1.09, 95% CI
0.61 to 1.94
Computer generated
randomisation in
sealed envelopes
Is there a relationship between antepartum pelvic examination to premature rupture of the membranes?
Study Ref Population Intervention Outcomes Results Comments Study
Lenihan,
1984
9 349 pregnant women Randomised allocation to one of the
two groups:
- Group 1 (n=175): no pelvic
examination or past term
- Group 2 (n=174): weekly pelvic
examination starting at 37 weeks
gestation
Incidence of PROM Group 1: 6%
Group 2: 18%
= a significant increase
(p=.001)
EL
type
RCT 1b
EL
type
RCT 1b