Document Detail


Short cervical length by ultrasound and cerclage.
MedLine Citation:
PMID:  10802840     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether gravidas with short cervical length on endovaginal ultrasound examination, not in preterm labor, who underwent cervical cerclage have better outcomes compared with those with no cerclage. METHODS: This is an observational study in which data were collected prospectively on women who had ultrasound endovaginal cervical length measurement and were not in preterm labor. The subgroup of women who were < or = 26 weeks' at cervical measurement was analyzed separately. Short cervix was defined as < or = 30 mm. After delivery, charts were reviewed for management and outcomes, performed at the discretion of the attending obstetrician. Two study groups were defined: those with cerclage and those with no cerclage. Predictor variables were cerclage and cervical lengths. Outcome variables were birth weight, gestational age at delivery, and neonatal outcomes. Data were analyzed using the chi-squared, Fisher's exact, and Student's t-tests, a p value of < 0.05 was considered to be significant. RESULTS: A total of 85 patients with cervical lengths of < or = 30 mm were identified; of these 43 had cerclage, and 42 did not. The latter had bedrest, tocolytics, or no intervention. Indications for cervical length measurement were similar in both groups, as were age, insurance status, cervical measurements, preterm premature rupture of membranes, and mode of delivery. The mean gestational age at delivery and birth weight in the cerclage group (34.0 +/- 5.4 weeks'; 2530 +/- 905 gm) were greater than in the no cerclage group (32.0 +/- 6.0 weeks', 2084 +/- 1085 gm, p values of < 0.04 and < 0.04, respectively). Analysis for the subgroup of women who were < or = 26 weeks at first measurement revealed similar results. The relative risk for delivering at < 30 weeks' gestation, for incrementally shorter cervices, was less in the cerclage group. CONCLUSION: Cerclage in gravidas with short cervix measured by endovaginal ultrasound, not in preterm labor, may be associated with neonates of greater gestational age and birth weight, with fewer of these parturients delivering before 30 weeks' gestation. A prospective randomized trial of treatment modalities for asymptomatic shortened cervix is needed.
Authors:
J U Hibbard; J Snow; A H Moawad
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  20     ISSN:  0743-8346     ISO Abbreviation:  J Perinatol     Publication Date:    2000 Apr-May
Date Detail:
Created Date:  2000-07-12     Completed Date:  2000-07-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  161-5     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Pritzker School of Medicine, University of Chicago, IL 60637, USA. jhibbard@babies.bsd.uchicago.edu
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MeSH Terms
Descriptor/Qualifier:
Birth Weight
Cervix Uteri / surgery,  ultrasonography*
Delivery, Obstetric / methods
Endosonography*
Female
Gestational Age
Gynecologic Surgical Procedures / methods*
Humans
Infant Mortality
Infant, Newborn
Pregnancy
Pregnancy Outcome
Prognosis
Suture Techniques*
Uterine Cervical Incompetence / surgery*,  ultrasonography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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