Factors associated with spontaneous preterm birth risk assessed by transvaginal ultrasound following cervical cerclage

Shirlene Sim, Fabricio Da Silva Costa, Edward Araujo Júnior, Penelope M. Sheehan

Research output: Contribution to journalArticleResearchpeer-review

8 Citations (Scopus)

Abstract

Objective To determine the predictive value of various cervical length measurements postcerclage for the outcome of preterm birth following both elective and rescue cerclage. Materials and Methods Over a five-year period, we identified 59 women who had a transvaginal cerclage inserted followed by serial cervical length measurement. Of these, 18 were elective cerclages placed at 14 weeks of gestation on the basis of a history of cervical insufficiency and 41 were rescue cerclages performed at gestations ranging from 17 to 23 weeks following a diagnosis of shortened cervix on ultrasound. The women were asymptomatic throughout. Results There was a strong correlation between cervical length postcerclage and gestation at delivery. For both groups, preterm birth could be predicted by the total cervical length. In the rescue cerclage group, the change in cervical length was predictive, with positive changes associated with later gestation at delivery. The presence of funnelling was predictive of preterm birth in the elective cerclage group only. Conclusion Transvaginal cervical length measurement is useful in the prediction of preterm birth postcerclage placement. Serial cervical length measurement postcerclage may assist with timely addition of interventions such, progesterone and antenatal cortico steroids for fetal lung maturation.

Original languageEnglish
Pages (from-to)344-349
Number of pages6
JournalAustralian and New Zealand Journal of Obstetrics and Gynaecology
Volume55
Issue number4
DOIs
Publication statusPublished - Aug 2015
Externally publishedYes

Keywords

  • cervical cerclage
  • cervical length
  • prediction
  • preterm birth
  • transvaginal ultrasound

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