Longitudinal Assessment of Endocervical Canal Length Between 15 and 24 Weeks' Gestation in Women at Risk for Pregnancy Loss or Preterm Birth

Abstract

Weekly rates of endocervical canal length shortening were established, which may be useful for detecting and managing cervical incompetence in high-risk women examined with cervical sonography.

Follow-up cervical length in asymptomatic high-risk women and the risk of spontaneous preterm birth

“…26,[29][30][31][32][33][34][35][36][37] Many of these studies, however, evaluated low-risk women 29,30,32,34 or those with symptoms of preterm labor. 37 Several studies have evaluated cervical shortening in high-risk women finding conflicting results, with some suggesting it added additional predictive value, 26,31,33 whereas others found it did not.…”

“…26,[29][30][31][32][33][34][35][36][37] Many of these studies, however, evaluated low-risk women 29,30,32,34 or those with symptoms of preterm labor. 37 Several studies have evaluated cervical shortening in high-risk women finding conflicting results, with some suggesting it added additional predictive value, 26,31,33 whereas others found it did not. 35 Shortcomings of previous studies include the fact that many did not evaluate only those identified with a short cervical length, 26,[31][32][33][34] and studies that included only asymptomatic women with singleton gestations found to have a short cervical length did not evaluate other perinatal outcomes apart from preterm birth or gestational age at delivery.…”

“…37 Several studies have evaluated cervical shortening in high-risk women finding conflicting results, with some suggesting it added additional predictive value, 26,31,33 whereas others found it did not. 35 Shortcomings of previous studies include the fact that many did not evaluate only those identified with a short cervical length, 26,[31][32][33][34] and studies that included only asymptomatic women with singleton gestations found to have a short cervical length did not evaluate other perinatal outcomes apart from preterm birth or gestational age at delivery. 26,35 One study of asymptomatic high-risk women found that the cervical length measurement and the gestational age at transvaginal ultrasonography significantly affected the risk of spontaneous preterm birth.…”

“…[16][17][18][19] Cervical length measured by transvaginal ultrasonography has been shown to predict preterm birth in these asymptomatic high-risk women. 13,[20][21][22][23][24][25][26][27][28] Some studies have suggested that cervical length shortening by transvaginal ultrasonography may further increase the risk of preterm birth, 26,[29][30][31][32][33][34] whereas other studies have not noted this association. [35][36][37] There is a limited information regarding the benefit of follow-up cervical length ultrasound in high-risk asymptomatic women found to have a short cervical length.…”

Comparison of transvaginal sonography in recumbent and standing maternal positions to predict spontaneous preterm birth in singleton and twin pregnancies

“…Guzman et al 30 established rates of CL shortening from 15 weeks onwards to demonstrate that a rapid change reflects the degree of incompetence. In patients with an incompetent cervix, shortening between 20 and 24 weeks varied from 4.9 to 8 mm, which is the rate between 15 weeks to term in normal pregnancies.…”