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Change in cervical length in cases resulting in threatened preterm labor

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Abstract

Purpose

To determine the predisposing changes in cervical length (CL) and the critical range of CL in which significant uterine contractions emerge resulting in threatened preterm labor (TPL).

Methods

Sixty-eight uncomplicated singleton pregnancies where the CL was <25 mm before 31 weeks were divided into cases with TPL (n = 23) or without (n = 45). CL and uterine contractions were monitored sequentially starting between 16 and 20 weeks. The gestational ages when a CL of <25 or <15 mm was first observed, the interval between these two measurements, and the CL value at TPL diagnosis were analyzed retrospectively.

Results

(1) The gestational ages when a CL of <25 and <15 mm was first detected were lower in the TPL group (25 (median); 18–30 (range) and 28; 25–33 weeks, respectively) than in the non-TPL group (27; 20–30 and 33; 26–35 weeks; P = 0.030 and P < 0.001). (2) The interval between the two measurements was shorter in the TPL group (2.5; 0–15 weeks) than in the non-TPL group (5.5; 0–13 weeks, P = 0.034). (3) The CL value at TPL diagnosis was 13 mm (median), ranging from 7 to 18 mm.

Conclusion

Cases with early onset and subsequent rapid CL shortening before 31 weeks resulted in TPL when CL decreased below the range 7–18 mm.

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References

  1. Andrews WW, Copper R, Hauth JC, Goldenberg RL, Neely C, Dubard M. Second-trimester cervical ultrasound: associations with increased risk for recurrent early spontaneous delivery. Obstet Gynecol. 2000;95:222–6.

    Article  CAS  PubMed  Google Scholar 

  2. Cook CM, Ellwood DA. The cervix as a predictor of preterm delivery in ‘at-risk’ women. Ultrasound Obstet Gynecol. 2000;15:109–13.

    Article  CAS  PubMed  Google Scholar 

  3. Heath VCF, Southall TR, Souka AP, Elisseou A, Nicolaides KH. Cervical length at 23 weeks of gestation: prediction of spontaneous preterm delivery. Ultrasound Obstet Gynecol. 1998;12:312–7.

    Article  CAS  PubMed  Google Scholar 

  4. Owen J, Yost N, Berghella V, et al. Can shortened midtrimester cervical length predict very early spontaneous preterm birth? Am J Obstet Gynecol. 2004;191:298–303.

    Article  PubMed  Google Scholar 

  5. Taipale P, Hiilesmaa V. Sonographic measurement of uterine cervix at 18–22 weeks’ gestation and the risk of preterm delivery. Obstet Gynecol. 1998;92:902–7.

    Article  CAS  PubMed  Google Scholar 

  6. Tsoi E, Akmal S, Rane S, Otigbah C, Nicolaides KH. Ultrasound assessment of cervical length in threatened preterm labor. Ultrasound Obstet Gynecol. 2003;21:552–5.

    Article  CAS  PubMed  Google Scholar 

  7. Fuchs IB, Henrich W, Osthues K, Dudenhausen JW. Sonographic cervical length in singleton pregnancies with intact membranes presenting with threatened preterm labor. Ultrasound Obstet Gynecol. 2004;24:554–7.

    Article  CAS  PubMed  Google Scholar 

  8. Palacio M, Sanin-Blair J, Sanchez M, et al. The use of a variable cut-off value of cervical length in women admitted for preterm labor before and after 32 weeks. Ultrasound Obstet Gynecol. 2007;29:421–6.

    Article  CAS  PubMed  Google Scholar 

  9. Schmitz T, Kayem G, Maillard F, Lebret MT, Cabrol D, Goffinet F. Selective use of sonographic cervical length measurement for predicting imminent preterm delivery in women with preterm labor and intact membranes. Ultrasound Obstet Gynecol. 2008;31:421–6.

    Article  CAS  PubMed  Google Scholar 

  10. Berghella VB, Iams JD, Newman RB, MacPherson C, Goldberg RL, Mueller-Heubach E, et al. Frequency of uterine contractions in asymptomatic pregnant women with or without a short cervix on transvaginal ultrasound scan. Am J Obstet Gynecol. 2004;191:1253–6.

    Article  PubMed  Google Scholar 

  11. Cook CM, Ellwood DA. Is there a relationship between uterine activity and the length of the cervix in the second trimester? J Obstet Gynaecol Res. 2000;26:347–50.

    Article  CAS  PubMed  Google Scholar 

  12. Yoshizato T, Obama H, Nojiri T, Miyake Y, Miyamoto S, Kawarabayashi T. Clinical significance of cervical length shortening before 31 weeks’ gestation assessed by longitudinal observation using transvaginal ultrasonography. J Obstet Gynaecol Res. 2008;34:805–11.

    Article  PubMed  Google Scholar 

  13. Gramellini D, Fieni S, Molina F, Berretta R, Vadora E. Transvaginal sonographic cervical length changes during normal pregnancy. J Ultrasound Med. 2002;21:227–32.

    PubMed  Google Scholar 

  14. Gomez R, Romero R, Nien JK, Chaiworapongsa T, Medina L, Kim YM, et al. A short cervix in women with preterm labor and intact membranes: a risk for microbial invasion of the amniotic cavity. Am J Obstet Gynecol. 2005;192:678–89.

    Article  PubMed  Google Scholar 

  15. Holst RM, Jacobsson B, Hagberg H, Wennerholm UB. Cervical length in women in preterm labor with intact membranes: relationship to intra-amniotic inflammation/microbial invasion, cervical inflammation and preterm delivery. Ultrasound Obstet Gynecol. 2006;28:768–74.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported in part by the Ogya Foundation, Japan.

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Authors and Affiliations

  1. Center for Maternal, Fetal and Neonatal Medicine, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan, Fukuoka, 814-0180, Japan

    Toshiyuki Yoshizato

  2. Department of Obstetrics and Gynecology, School of Medicine, Fukuoka University, Fukuoka, Japan

    Hiroshi Tsujioka, Shinji Horiuchi, Kyoko Shirota, Hirotsugu Obama, Takeshi Nojiri & Shingo Miyamato

  3. Department of Biochemistry School of Medicine, Fukuoka University, Fukuoka, Japan

    Fusanori Yotsumoto

Authors
  1. Toshiyuki Yoshizato
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  2. Hiroshi Tsujioka
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  3. Shinji Horiuchi
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  4. Kyoko Shirota
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  5. Hirotsugu Obama
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  6. Takeshi Nojiri
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  7. Fusanori Yotsumoto
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  8. Shingo Miyamato
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Correspondence to Toshiyuki Yoshizato.

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Yoshizato, T., Tsujioka, H., Horiuchi, S. et al. Change in cervical length in cases resulting in threatened preterm labor. J Med Ultrasonics 37, 195–200 (2010). https://doi.org/10.1007/s10396-010-0279-2

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  • DOI: https://doi.org/10.1007/s10396-010-0279-2

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