Document Detail


Transvaginal Ultrasonographic Cervical Length in Asymptomatic High Risk Women with a Short Cervical Length in the Previous Pregnancy.
MedLine Citation:
PMID:  21425200     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To determine if high risk asymptomatic women with a short cervical length in their previous pregnancy who delivered at term are at an increased risk of having a short cervical length in the next pregnancy, and whether they are at an increased risk of preterm birth. METHODS: This retrospective cohort study included high risk asymptomatic women(including those with a history of spontaneous preterm birth(SPTB), uterine anomaly, or excisional treatment for cervical dysplasia) who were pregnant with singleton gestations delivering April 2003 to March 2010, who had a previous pregnancy, and who had transvaginal ultrasonographic cervical length measurements performed 16-30 weeks gestation in both pregnancies. Comparison was among women who had a short cervical length(<3.0cm) in their previous pregnancy but delivered at term in that pregnancy(Short Term group), women with a history of a normal cervical length(≥3.0cm) in their previous pregnancy delivering at term(Long Term group), and women who had a short cervical length(<3.0cm) in their previous pregnancy delivering preterm(Short Preterm group). Primary outcomes were SPTB<37weeks and cervical length. Secondary outcomes were SPTB<35weeks, <32weeks, low birth weight, maternal outcomes and neonatal morbidity. RESULTS: A total of 62 women were included. Women in the Short Term group were more likely to have a short cervical length in the next pregnancy compared with those in the Long Term group(10/23[43.5%] versus 4/26[15.4%] respectively) but not as likely as women in the Short Preterm group(9/13[69.2%],P = 0.003). Women in the Short Term group were not at an increased risk of SPTB<37 weeks in the next pregnancy compared with women in the Long Term group(2/23[8.7%] versus 2/26[7.7%] respectively), but women in the Short Preterm group were at an increased risk(6/13[46.2%],P<0.0001). Compared with women in the Short Term and Long Term groups, women in the Short Preterm group were also at an increased risks of threatened preterm labor(6/23[26.1%] and 4/26[15.4%] versus 9/13[69.2%],P = 0.002) and receiving corticosteroids for fetal lung maturation(6/23[26.1%] and 4/26[15.4%] versus 11/13[84.6%],P<0.0001). CONCLUSION: Although high risk asymptomatic women with a short cervical length in their previous pregnancy who delivered at term are at an increased risk of having a short cervical length in the next pregnancy, they are not at an increased risk of preterm birth. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
Joan Mg Crane; Donna Hutchens
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-21
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Department of Obstetrics and Gynecology, Eastern Health, Memorial University, St. John's, Newfoundland, Canada. joan.crane@easternhealth.ca.
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