Prediction of risk for preterm delivery by ultrasonographic measurement of cervical length

Article Abstract:

Preterm (premature) delivery occurs more frequently in women with early cervical effacement (shortening of the cervix, or neck of the uterus), but the cervix is not routinely assessed to evaluate this risk. Endovaginal ultrasonography (an imaging technique) allows measurement of the cervical length, and it was hypothesized that cervical shortening in pregnancy would be associated with a greater risk of preterm delivery. To test this hypothesis, 113 patients who met certain criteria were studied with ultrasound to obtain cervical length measurements. All patients had been evaluated by 30 weeks' gestation. Results showed that patients whose average cervical length was shorter were more likely to have preterm deliveries; the risk of this complication for women with cervical lengths below the 50th percentile was 3.7 times the risk for women above the 50th percentile. This result was obtained using several approaches to cervical measurement. The relationship between cervical shortening and preterm delivery risk was especially strong for women who were pregnant with their first child, or who had no previous preterm delivery. Thus, cervical measurement could serve as a screening tool for pregnant women. Reasons for this relationship are not known. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Measurement, Risk factors, Cervix uteri, Premature labor, Diagnosis, Ultrasonic, Diagnostic ultrasonography

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Elective repeat cesarean delivery versus trial of labor: a meta-analysis of the literature from 1989 to 1999

Article Abstract:

Women with a previous cesarean delivery who attempt a vaginal delivery during a subsequent pregnancy have a risk of uterine rupture and a higher rate of infant death. This was the conclusion of researchers who reviewed 15 studies covering 47,682 pregnant women.

Complications and side effects, Uterus, Vaginal birth after cesarean, Uterine perforation

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Predicting preterm birth: a cost-effectiveness analysis

Article Abstract:

Treating all pregnant women at risk of premature labor may not be cost-effective. In a study of 9 different treatment strategies, the cheapest treatment caused more deaths and more cases of fetal respiratory distress syndrome than the most expensive treatment.

Reports, Prevention, Cost benefit analysis, Premature birth

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