Cervical length surveillance for predicting spontaneous preterm birth in women with uterine anomalies: A cohort study

Hughes, Kathryn Clare; Kane, Stefan C.; Haines, Terrence Peter; Sheehan, Penelope M.

doi:10.1111/aogs.13923

Cited by 9 publications

(10 citation statements)

References 26 publications

(51 reference statements)

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“…The risk of preterm birth in unborn women with a major uterine defect (uterus didelphys, unicornuate, bicornuate) is 19.6%, in women with a history of obstetrics 15.9%, and in women who have had a preterm birth 57.1% [ 18 ]. Another cohort study shows the risk of preterm birth in individual uterine malformations [ 6 ]. Women with a bicornuate uterus have the highest risk of preterm birth with 59.3%, with a septate uterus and a double uterus with 17.44%.…”

Section: Discussionmentioning

confidence: 99%

“…Women with a bicornuate uterus have the highest risk of preterm birth with 59.3%, with a septate uterus and a double uterus with 17.44%. For a unicornuate uterus, the risk of preterm birth is 5.81% [ 6 ]. In this case, the pregnancy of a 26-year-old primigravida with a double uterus was terminated at the expected date of 40 + 1 Hbd.…”

Section: Discussionmentioning

confidence: 99%

“…Above all, there is an increased risk of spontaneous miscarriage, preterm births, births in the breech position, and a reduced number of live births compared to a normal uterus [ 5 ]. Preterm births occur in approximately 17.44% to 33.3% of women with uterus didelphys [ 6 ]. The diagnosis is made on the basis of imaging studies—ultrasound, HSG, and MRI.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Impact of Uterus Didelphys on Fertility and Pregnancy

Ćwiertnia

Borzyszkowska

Golara

et al. 2022

IJERPH

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Uterus didelphys occurs as a result of abnormal fusion of the paramesonephric ducts and is characterized by complete duplication of uterine horns, cervix, and very often also the vagina or presence of longitudinal vaginal septum. Most women with a uterus didelphys are asymptomatic; some cases may coincide with dyspareunia or dysmenorrhea. The anomaly is associated with a higher risk of miscarriage, preterm labor, breech delivery, and decreased live births. We present the case of a 26-year-old woman (primigravida) who was known to have uterus didelphys. The diagnosis was made when the patient was 23 years old using ultrasound and hysteroscopy. The patient became pregnant after 18 months of efforts. The patient was referred to prenatal care in the 13th week of pregnancy with vaginal bleeding. In the 23rd week of pregnancy, gestation cholelithiasis was diagnosed. The pregnancy progressed without obstetric complications and the fetus developed normally. Due to the vaginal septum and fact that the patient felt stressed, the pregnancy was terminated at term by cesarean section. We concluded that uterus didelphys can be asymptomatic making an early diagnosis difficult. A pregnancy belongs to a high-risk group and more attention should be paid to this case. Cesarean section should be considered, especially in case of the presence of vaginal septum.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Impact of Uterus Didelphys on Fertility and Pregnancy

Ćwiertnia

Borzyszkowska

Golara

et al. 2022

IJERPH

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“…Uterus didelphys is a high-risk factor for cervical insufficiency, and closely associated with late miscarriage and preterm birth. Hughes et al reported that the incidence of preterm birth before 34 and 37 weeks in patients with uterus didelphys was approximately 20% and 40%, respectively 7 . Studies regarding the prevalence of cervical insufficiency in uterus didelphys remain limited.…”

Section: Discussionmentioning

confidence: 99%

Two Successful Livebirths from Both Hemiuteruses After Laparoscopic Cervical Cerclage in a Uterus Didelphys Patient with Cervical Insufficiency

Zhang¹,

Zhang²,

Chen³

et al. 2022

Maternal-Fetal Medicine

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Uterus didelphys occurs in ∼0.4% of females and is found in ∼11%-20% of all uterus defects. It is a risk factor for cervical insufficiency, consequently contributing to late miscarriage or preterm birth. Thus far, only two prior cases of uterus didelphys accompanied by cervical insufficiency treated through laparoscopic cervical cerclage have been reported; however, livebirth only occurred in one hemiuterus. Herein, we report a case of uterus didelphys in a patient diagnosed with cervical insufficiency. Following the placement of a modified laparoscopic cervical cerclage, the patient had two successful livebirths through both hemiuteruses, respectively, with longer gestation age (ie, >36 weeks). The aim of this case report was to provide useful information for clinical practitioners to make better decisions on the management of cervical insufficiency in patients with uterus didelphys, and identify obstetric complications that clinicians should pay attention to during pregnancy.

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“…Women with a congenital uterine anomaly, fibroids or pre-existing medical condition that could affect the cervical connective structure are at increased risk of spontaneous PTB, particularly women with unicornuate uterus or uterus didelphys, these being related more to late than to early PTB [120][121][122] . However, screening for short cervix by second-trimester TVS CL surveillance is only moderately predictive of PTB at 24 weeks in patients with a septate uterus 120 . Therefore, this group of women should also benefit from the same predictive and preventive strategies as pregnant women with a history of conization/LEEP.…”

Section: Additional Non-modifiable Risk Factors Associated With Spont...mentioning

confidence: 99%

ISUOGPractice Guidelines: role of ultrasound in the prediction of spontaneous preterm birth

Coutinho

Sotiriadis

Odibo

et al. 2022

Ultrasound in Obstet & Gyne

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and Gynecology (ISUOG) is a scientific organization that encourages sound clinical practice and high-quality teaching and research related to diagnostic imaging in women's healthcare. The ISUOG Clinical Standards Committee (CSC) has a remit to develop Practice Guidelines and Consensus Statements as educational recommendations that provide healthcare practitioners with a consensus-based approach, from experts, for diagnostic imaging. They are intended to reflect what is considered by ISUOG to be the best practice at the time at which they are issued. Although ISUOG has made every effort to ensure that Guidelines are accurate when issued, neither the Society nor any of its employees or members accepts liability for the consequences of any inaccurate or misleading data, opinions or statements issued by the CSC. The ISUOG CSC documents are not intended to establish a legal standard of care, because interpretation of the evidence that underpins the Guidelines may be influenced by individual circumstances, local protocol and available resources. Approved Guidelines can be distributed freely with the permission of ISUOG (

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Cervical length surveillance for predicting spontaneous preterm birth in women with uterine anomalies: A cohort study

Cited by 9 publications

References 26 publications

The Impact of Uterus Didelphys on Fertility and Pregnancy

The Impact of Uterus Didelphys on Fertility and Pregnancy

Two Successful Livebirths from Both Hemiuteruses After Laparoscopic Cervical Cerclage in a Uterus Didelphys Patient with Cervical Insufficiency

ISUOGPractice Guidelines: role of ultrasound in the prediction of spontaneous preterm birth

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