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Long cervix in mid-pregnancy a predictor of cesarean delivery at term
Monday, 29 November 1999 19:00 | 
| Radiology News - Radiology Articles |
The risk of emergency cesarean delivery at term among primiparous women is higher among those with a cervical length of 25 mm or more during the sixth month of pregnancy, British researchers report in the NEJM.
"The risk of emergency cesarean delivery at term among primiparous women is higher among those with a cervical length of 25 mm or more during the sixth month of pregnancy, British researchers report in the New England Journal of Medicine for March 27.
A short cervix in mid-pregnancy is associated with an increased risk of spontaneous preterm birth, lead author Dr. Gordon C. S. Smith at Cambridge University and his associates note. Their research was designed to see if the converse is true, that a long cervix would predict difficulty delivering at term.
Their study included 27,472 primiparous women who had a cervical length of 16 mm or more determined by transvaginal ultrasonography between 22 and 24 weeks of gestation, and who delivered at term.
"Rates of cesarean delivery started to rise at a cervical length of 25 mm and plateaued at a cervical length of 50 mm, approximately doubling across the range of observed values," Dr. Smith's team reports.
The increased risk of cesarean delivery with longer mid-pregnancy cervix was attributable to poor progress of labor. The association was similar for different body weights and was consistent "across strata of other maternal and outcome factors and across the eight hospitals studied."
Dr. Smith and his colleagues suggest that "poor progress during labor in women who deliver at term may be related to dysfunctional development of the uterus at much earlier stages of pregnancy."
A short cervix in mid-pregnancy is associated with an increased risk of spontaneous preterm birth, lead author Dr. Gordon C. S. Smith at Cambridge University and his associates note. Their research was designed to see if the converse is true, that a long cervix would predict difficulty delivering at term.
Their study included 27,472 primiparous women who had a cervical length of 16 mm or more determined by transvaginal ultrasonography between 22 and 24 weeks of gestation, and who delivered at term.
"Rates of cesarean delivery started to rise at a cervical length of 25 mm and plateaued at a cervical length of 50 mm, approximately doubling across the range of observed values," Dr. Smith's team reports.
The increased risk of cesarean delivery with longer mid-pregnancy cervix was attributable to poor progress of labor. The association was similar for different body weights and was consistent "across strata of other maternal and outcome factors and across the eight hospitals studied."
Dr. Smith and his colleagues suggest that "poor progress during labor in women who deliver at term may be related to dysfunctional development of the uterus at much earlier stages of pregnancy."
