Cervical length at 23 weeks of gestation: prediction of spontaneous preterm delivery

Heath, V.; Southall, T.; Souka, Athena P.; Elisseou, A.; Nicolaides, Kypros H.

doi:10.1046/j.1469-0705.1998.12050312.x

Cited by 472 publications

(388 citation statements)

References 11 publications

(19 reference statements)

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“…1,5,17 We have demonstrated a biologically predictable, differential benefit of cerclage when the cervical length is very short, less than 15 mm. We chose a priori to examine 15 mm as an alternate cutoff to define shortened cervical length, because this has been utilized by other investigators to assess both the predictive value of sonographic cervical length 6 and cerclage effectiveness for shortened cervical length. 7,13 Still unclear are the factors which incite pathologic cervical shortening in these women.…”

Section: Commentmentioning

confidence: 99%

“…1,2 Originally proposed for use in women with recurrent mid-trimester pregnancy loss that was unaccompanied by bleeding, contractions, infection, or ruptured membranes, 3 cerclage has subsequently been more broadly recommended for women with a history of preterm birth, especially if the gestational age at birth was less than 26 weeks. 4 Ultrasound studies 5,6 showing that the cervix appeared to shorten without contractions in women destined for preterm birth led many to consider cerclage as prophylaxis, [7][8][9] but several randomized trials have not supported this practice. [10][11][12] Althuisius et al observed a significant benefit in a small clinical trial of women whose history or symptoms suggested cervical insufficiency; preterm birth before 35 weeks of gestation was observed in 44% of the no-cerclage group versus none of the women who were assigned to receive cerclage (p = 0.002).…”

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confidence: 99%

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Multicenter Randomized Trial of Cerclage for Preterm Birth Prevention in High-Risk Women With Shortened Midtrimester Cervical Length

Owen

Hankins

Iams

et al. 2010

Obstetrical &Amp; Gynecological Survey

122

182

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Section: Commentmentioning

confidence: 99%

mentioning

confidence: 99%

Multicenter Randomized Trial of Cerclage for Preterm Birth Prevention in High-Risk Women With Shortened Midtrimester Cervical Length

Owen

Hankins

Iams

et al. 2010

Obstetrical &Amp; Gynecological Survey

122

182

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“…Transvaginal ultrasonographic assessment of cervical length at 22 -24 weeks of gestation provides useful prediction of spontaneous early preterm delivery 1,2 . Cervical assessment can also be carried out by transabdominal and transperineal sonography and these alternative routes may be more acceptable to some women.…”

Section: Introductionmentioning

confidence: 99%

Cervical length at 22–24 weeks of gestation: comparison of transvaginal and transperineal‐translabial ultrasonography

Cicero

Skentou

Souka

et al. 2001

Ultrasound in Obstet & Gyne

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“…These findings were different from that found in another study. 13 In the 13 patients who had cervical funneling, 76.9% (n=10) had preterm delivery and cervical funneling was statistically significant (p value=<0.001).…”

mentioning

confidence: 88%

Transvaginal sonographic evaluation of cervical length in the second trimester as a risk factor for preterm delivery

Sherafudeen

Viswanath

Joseph

2018

Int J Reprod Contracept Obstet Gynecol

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Background: Preterm delivery continues to be a significant obstetric problem in view of prematurity complications that an immature new born develops. Cervical length is considered to be one of the important predictors of the risk of preterm delivery. There are only a few studies evaluating cervical length as risk factor for preterm delivery in the Indian population. The present study is undertaken to estimate the risk of preterm delivery in women with cervical length < 2.5 cm measured by transvaginal sonography at 18-24 weeks of gestation in South Indian population. Methods: All booked singleton pregnancies attending the Out Patient Department OPD at SAT Hospital Trivandrum, who have the correct dating and came for anomaly scan between 18-24 weeks were included for cervical length measurement with transvaginal ultrasound scanning. Selected patients were then followed till pregnancy was terminated. The outcome of pregnancy in term of period of gestation at delivery was assessed. Results: A total of 202 antenatal patients were followed up from 18-24 weeks of gestation till their termination of pregnancy and among these 101 patients had a cervical length <2.5 cm. The mean cervical length in patients with preterm delivery (n=63) was 2.4 cm and in term delivery (n=139) was 2.91 cm respectively. Of the total patients (n=202) followed, 31.2% (n=63) had preterm delivery whereas 68.8% (n=139) had term delivery. In the 101 patients with cervical length <2.5 cm, 76.2% (n=48) had preterm delivery when compared to 23.8% (n=15) of patients with cervical length>2.5 cm (n=101). The cervical length of <2.5 cm at 18-24 weeks of gestation was found to be statistically significant (p value-<0.001) in relation to outcome of delivery. The relative risk for preterm delivery in patients with cervical length<2.5 cm was 3.2 times that of patients with >2.5cm. The history of previous preterm delivery was found to be statistically significant (p value=<0.001) for preterm labour in future pregnancies. The relative risk for preterm delivery in patients with previous history of preterm labour was 3 times when compared to patients with previous term delivery. Patients with history of UTI (urinary tract infection) had 2.3 times risk for preterm delivery and relative risk for preterm delivery in patient with vaginitis was 6.8 times. The cervical length of <2.5 cm and vaginitis are independent risk factor for preterm delivery. Conclusions: Short cervix (cervical length <2.5 cm) at 18-24 weeks of gestation is a risk factor for preterm delivery. A cervical length <2.5 cm has a relative risk of 3 for preterm delivery. Previous history of preterm birth has 3 times increased risk of preterm delivery in future pregnancies. History of urinary tract infection and vaginitis also increases risk of preterm delivery. The cervical length at 18-24 weeks, history of vaginitis and UTI were found to be independent risk factors for preterm delivery.

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Cervical length at 23 weeks of gestation: prediction of spontaneous preterm delivery

Abstract: Cervical length at 23 weeks is < or = 15 mm in < 2% of the population; this group contains about 90% and 60% of the women delivering at < or = 28 and < or = 32 weeks, respectively. Measurement of cervical length provides accurate prediction of risk for early preterm delivery.

Cited by 472 publications

References 11 publications

Multicenter Randomized Trial of Cerclage for Preterm Birth Prevention in High-Risk Women With Shortened Midtrimester Cervical Length

Multicenter Randomized Trial of Cerclage for Preterm Birth Prevention in High-Risk Women With Shortened Midtrimester Cervical Length

Cervical length at 22–24 weeks of gestation: comparison of transvaginal and transperineal‐translabial ultrasonography

Transvaginal sonographic evaluation of cervical length in the second trimester as a risk factor for preterm delivery

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