Universal maternal cervical length screening during the second trimester: pros and cons of a strategy to identify women at risk of spontaneous preterm delivery

AbstractThe objective of our study was to evaluate the correlation of the cervical length at 20–25 weeks of gestation with the incidence of spontaneous preterm delivery in twins in a country with a high incidence of preterm delivery compared to other European countries. Cervical length was measured in 262 consecutive patients. Previous preterm delivery before 34 weeks of gestation, chorionicity, maternal age, body-mass-index, smoking habit and parity were recorded as risk factors for preterm delivery. Women who were symptomatic at 20–25 weeks and who delivered because of other reasons than spontaneous labour and preterm rupture of membranes or at term were excluded. The primary outcome was incidence of preterm birth before 34 weeks. Two hundred and twenty-three patients were analyzed. Thirty-two (14%) delivered before 34 weeks. There was a significant correlation between cervical length of less than 25 mm and spontaneous delivery before 34 weeks (50% vs. 13%,p= .007). In addition, logistic regression analysis found cervical length to be the only significant predictor of spontaneous delivery before 34 weeks (OR 1.084; 95% CI 1.015; 1.159;p= .017). We conclude that the risk of severe preterm delivery in twins is high. Cervical length at mid-gestation was the only predictor of delivery before 34 weeks.

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339: Comparison of the natural pattern of cervical length change in women at risk for preterm delivery who deliver before and after 34 weeks gestation

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2009.10.354 ◽

2009 ◽

Vol 201 (6) ◽

pp. S133-S134

Author(s):

Scarlett Karakash ◽

Juliana Gebb ◽

Laura Reimers ◽

Hye Heo ◽

Peer Dar

Keyword(s):

At Risk ◽

Preterm Delivery ◽

Length Change ◽

Cervical Length ◽

Before And After ◽

Natural Pattern

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Cervical Length in the Early Second Trimester for Detection of Triplet Pregnancies at Risk for Preterm Birth

Journal of Ultrasound in Medicine ◽

10.7863/jum.2004.23.9.1187 ◽

2004 ◽

Vol 23 (9) ◽

pp. 1187-1191 ◽

Cited By ~ 13

Author(s):

Sharon Maslovitz ◽

Joseph Hartoov ◽

Igal Wolman ◽

Ariel Jaffa ◽

Joseph B. Lessing ◽

...

Keyword(s):

At Risk ◽

Preterm Birth ◽

Cervical Length ◽

Second Trimester

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EVALUATING THE EFFICIENCY OF MEASURING THE CERVICAL LENGTH AND FUNNELING BY TRANSVAGINAL SONOGRAM IN PREDICTION OF SPONTANEOUS PRETERM DELIVERY

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2018/533 ◽

2018 ◽

Vol 7 (19) ◽

pp. 2365-2371

Author(s):

Dhanalakshmi Kaliyamoorthy ◽

Gowri Arumugam Loganathan

Keyword(s):

Preterm Delivery ◽

Cervical Length ◽

Spontaneous Preterm Delivery

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A soft cervix, categorized by shear-wave elastography, in women with short or with normal cervical length at 18–24 weeks is associated with a higher prevalence of spontaneous preterm delivery

Journal of Perinatal Medicine ◽

10.1515/jpm-2018-0062 ◽

2018 ◽

Vol 46 (5) ◽

pp. 489-501 ◽

Cited By ~ 21

Author(s):

Edgar Hernandez-Andrade ◽

Eli Maymon ◽

Suchaya Luewan ◽

Gaurav Bhatti ◽

Mohammad Mehrmohammadi ◽

...

Keyword(s):

Cohort Study ◽

Preterm Delivery ◽

Shear Wave ◽

Wave Speed ◽

Shear Wave Elastography ◽

Cervical Length ◽

Singleton Pregnancy ◽

Short Cervix ◽

Shear Wave Speed ◽

Spontaneous Preterm Delivery

AbstractObjective:To determine whether a soft cervix identified by shear-wave elastography between 18 and 24 weeks of gestation is associated with increased frequency of spontaneous preterm delivery (sPTD).Materials and methods:This prospective cohort study included 628 consecutive women with a singleton pregnancy. Cervical length (mm) and softness [shear-wave speed: (SWS) meters per second (m/s)] of the internal cervical os were measured at 18–24 weeks of gestation. Frequency of sPTD <37 (sPTD<37) and <34 (sPTD<34) weeks of gestation was compared among women with and without a short (≤25 mm) and/or a soft cervix (SWS <25thpercentile).Results:There were 31/628 (4.9%) sPTD<37 and 12/628 (1.9%) sPTD<34 deliveries. The combination of a soft and a short cervix increased the risk of sPTD<37 by 18-fold [relative risk (RR) 18.0 (95% confidence interval [CI], 7.7–43.9); P<0.0001] and the risk of sPTD<34 by 120-fold [RR 120.0 (95% CI 12.3–1009.9); P<0.0001] compared to women with normal cervical length. A soft-only cervix increased the risk of sPTD<37 by 4.5-fold [RR 4.5 (95% CI 2.1–9.8); P=0.0002] and of sPTD<34 by 21-fold [RR 21.0 (95% CI 2.6–169.3); P=0.0003] compared to a non-soft cervix.Conclusions:A soft cervix at 18–24 weeks of gestation increases the risk of sPTD <37 and <34 weeks of gestation independently of cervical length.

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Association Between Cervical Length at 18-23 Weeks of Gestation and Spontaneous Preterm Delivery: A Cross Sectional Study

Case Reports in Obstetrics Gynecology and Reproductive ◽

10.31487/j.crogr.2020.03.02 ◽

2020 ◽

pp. 1-4

Author(s):

Trupti Ruge ◽

Emanuel Gracias

Keyword(s):

Preterm Birth ◽

Preterm Delivery ◽

Transvaginal Ultrasound ◽

Demographic Data ◽

Cross Sectional Study ◽

Cervical Length ◽

Sectional Study ◽

Cross Sectional ◽

Mortality And Morbidity ◽

Spontaneous Preterm Delivery

Introduction: Preterm birth is childbirth occurring at less than 37 completed weeks or 259 days of gestation, is a major determinant of neonatal mortality and morbidity and has long-term adverse consequences for health. Identifying ways to address preventable causes of preterm birth should be a top priority in developing regions of the world. the present study was planned to find the association between cervical length at 18 to 23 weeks of gestation done as a routine during all second level scans and spontaneous preterm delivery. Patients and Methods: This is a hospital based cross sectional study conducted during the period from January 2019 to December 2019. A total of 205 women presenting with singleton pregnancies between 18- 23 weeks of gestations were assessed by transvaginal ultrasound for the measurement of cervical length. Patients were interviewed and their demographic data such as age, obstetric index(GPALD), obstetric history such last menstrual period (LMP), estimated delivery date (EDD) and current pregnancy details such as BP, pulse rate, pallor, period of gestation, were recorded in a predesigned pro forma. Results: In a total of 205 subjects, the average age was found to be 23.26 ± 3.49 years with 52.2% of the women being primigravida. The mean gestation age at the time of enrollment was 20.72 ± 1.00 weeks with 33% of women showing a cervical length of 26-30 mm. The delivery outcome was found as 11% preterm, majority (89.27%) was term delivery. Conclusion: The present study showed that a significantly higher number of women with cervical length ≤ 30 mm (assessed at 18 to 23 weeks of gestation) had preterm labour compared to a woman with cervical length > 30 mm.

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