Transvaginal ultrasonographic measurement of cervical length in asymptomatic high-risk women with a short cervical length in the previous pregnancy

被引:10
作者
Crane, J. M. G. [1 ]
Hutchens, D. [1 ]
机构
[1] Mem Univ Newfoundland, Dept Obstet & Gynecol, St John, NF A1B 3V6, Canada
关键词
cervical length; loop electrosurgical excision procedure; preterm birth; transvaginal ultrasonography; uterine anomaly; PREDICT PRETERM BIRTH; INTRAEPITHELIAL NEOPLASIA; UTERINE ANOMALIES; RECURRENCE; ULTRASOUND; MORTALITY; DELIVERY; RATES; AGE; 2ND-TRIMESTER;
D O I
10.1002/uog.9004
中图分类号
O42 [声学];
学科分类号
070206 ; 082403 ;
摘要
Objective To determine if asymptomatic women at high risk of preterm delivery who had a short cervical length in their previous pregnancy and delivered at term are at increased risk of having a short cervical length in their next pregnancy, and whether they are at increased risk of preterm birth. Methods This retrospective cohort study included high-risk (those with a history of spontaneous preterm birth, uterine anomaly or excisional treatment for cervical dysplasia) asymptomatic women who were pregnant with a singleton gestation delivering between April 2003 and March 2010, who had had a previous pregnancy and who had transvaginal ultrasonographic cervical length measurement performed at 16-30 weeks' gestation in both pregnancies. Comparison was among women who had a short cervical length (< 3.0 cm) in their previous pregnancy but delivered at term in that pregnancy (Short Term Group), women with a history of a normal cervical length (>= 3.0 cm) in their previous pregnancy delivering at term (Long Term Group), and women who had a short cervical length (< 3.0 cm) in their previous pregnancy delivering preterm (Short Preterm Group). Primary outcomes were spontaneous preterm birth at < 37 weeks' gestation and cervical length. Secondary outcomes were spontaneous preterm birth at < 35 weeks and < 32 weeks, 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 their next pregnancy compared with those in the Long Term Group (10/23 (43.5%) vs. 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 spontaneous preterm birth at < 37 weeks in the next pregnancy compared with women in the Long Term Group (2/23 (8.7%) vs. 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 risk of threatened preterm labor (6/23 (26.1%) and 4/26 (15.4%) vs. 9/13 (69.2%), respectively; P = 0.002) and of receiving corticosteroids for fetal lung maturation (6/23 (26.1%) and 4/26 (15.4%) vs. 11/13 (84.6%), respectively; P < 0.0001). Conclusion Although high-risk asymptomatic women with a short cervical length in their previous pregnancy who delivered at term are at increased risk of having a short cervix in their next pregnancy, they are not at increased risk of preterm birth. Copyright (C) 2011 ISUOG. Published by John Wiley & Sons, Ltd.
引用
收藏
页码:38 / 43
页数:6
相关论文
共 29 条
  • [11] Transvaginal ultrasonography in the prediction of preterm birth after treatment for cervical intraepithelial neoplasia
    Crane, JMG
    Delaney, T
    Hutchens, D
    [J]. OBSTETRICS AND GYNECOLOGY, 2006, 107 (01) : 37 - 44
  • [12] CREASY RK, 1980, OBSTET GYNECOL, V55, P692
  • [13] Prediction of preterm delivery in the second trimester
    de Carvalho, MHB
    Bittar, RE
    Brzt, MD
    Bicudo, C
    Zugaib, M
    [J]. OBSTETRICS AND GYNECOLOGY, 2005, 105 (03) : 532 - 536
  • [14] Rates of recurrent preterm birth by obstetrical history and cervical length
    Durnwald, CP
    Walker, H
    Lundy, JC
    Iams, JD
    [J]. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2005, 193 (03) : 1170 - 1174
  • [15] Clinical implications of uterine malformations and hysteroscopic treatment results
    Grimbizis, GF
    Camus, M
    Tarlatzis, BC
    Bontis, JN
    Devroey, P
    [J]. HUMAN REPRODUCTION UPDATE, 2001, 7 (02) : 161 - 174
  • [16] SCHOOL-AGE OUTCOMES IN CHILDREN WITH BIRTH WEIGHTS UNDER 750 G
    HACK, M
    TAYLOR, HG
    KLEIN, N
    EIBEN, R
    SCHATSCHNEIDER, C
    MERCURIMINICH, N
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1994, 331 (12) : 753 - 759
  • [17] Iams JD, 1998, AM J OBSTET GYNECOL, V178, P1035, DOI 10.1016/S0002-9378(98)70544-7
  • [18] Pregnancy management after cervical surgery
    Jolley, Jennifer A.
    Wing, Deborah A.
    [J]. CURRENT OPINION IN OBSTETRICS & GYNECOLOGY, 2008, 20 (06) : 528 - 533
  • [19] Neonatal survival 1 - 4 million neonatal deaths: When? where? why?
    Lawn, JE
    Cousens, S
    Zupan, J
    [J]. LANCET, 2005, 365 (9462) : 891 - 900
  • [20] LUDMIR J, 1990, OBSTET GYNECOL, V75, P906