ABSTRACT
The purpose of this study was to describe how obstetricians in the community define a short cervix prior to cerclage placement. A secondary analysis of cerclages placed for the diagnosis of short cervix, defined by either digital or ultrasound examination, were identified from a cohort of 1076 cerclages placed at a community hospital from January 1, 2000, through December 31, 2004. Two hundred twenty-six cerclages were placed for the diagnosis of short cervix. Fifty-eight women (25.7%) were nulliparous. The mean estimated gestational age at placement was 15.4 ± 3.8 weeks. More than half of the cerclages (n = 125; 55.3%) were placed prior to 15 weeks estimated gestational age. Of those cases with documented cervical length by ultrasound (n = 171), 36 of these patients (21.1%) had a cervical length of ≥ 25 mm. The most common indications for cerclage placement were short cervix only (40.3%), previous cone biopsy/loop electrocautery excision procedure (28.8%), and multiple gestation (9.7%). In a community hospital, cerclages for short cervix are often performed in nulliparous women without antecedent risk factors at a gestational age when cervical length is not a reliable tool for predicting adverse pregnancy outcome.
KEYWORDS
Cervical length - cervical insufficiency - cerclage - short cervix
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Presented at the 27th Annual Meeting of the Society for Maternal-Fetal Medicine, February 5-10, 2007, San Francisco, California.
Carla A MartinezM.D.
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Health Science Center at Houston
6410 Fannin Street, Suite 3.430, Houston, TX 77030