Serial Cervical Length Evaluation in Low-Risk Women with Shortened Cervical Lengths in the Midtrimester: How Many Will Dilate Prior to 24 Weeks?

摘要

Objective To determine what proportion of women with a short cervical length (CL) without a history of spontaneous preterm birth (SPTB) will ultimately be dilated at Study Design This is a retrospective cohort study of women with singleton pregnancies with a short CL (<= 25 mm) between 16 and 22 weeks' gestational age (GA). We excluded women with a history of SPTB. We examined the progression of women with short CL based on the CL measurement and GA at diagnosis. The primary outcome was cervical dilation or spontaneous delivery Results A total of 163 women were included, of whom 27 (16.6%) were ultimately dilated and 4 (2.5%) had pregnancy loss by 24 weeks. The median GA at diagnosis of short CL was 19 (5/7) (range: 15-22) weeks. Women with a CL <15 mm were more likely to have cervical dilation or loss prior to 24 weeks than women whose CL was 15 to 25 mm (42.5 vs. 11.9%, <0.001, adjusted odds ratio: 3.72, 95% confidence interval: 1.52-9.09). GA at diagnosis was not associated with risk of progression. Conclusion In women with a short CL without a history of SPTB, the risk of dilation or pregnancy loss <24 weeks is significant, approaching 50% for women with a CL