Short cervix: is a follow-up measurement useful?

Abstract

Objective: To study if a repeat cervical length (CL) measurement in the patient already diagnosed with a short cervix has any additional value in the prediction of preterm delivery.

Study design: This was a retrospective study of singleton pregnancies with cervical lengths 1-25 mm at a gestational age of 16-28 weeks seen in our institution between 2002 and 2005. Patients who were managed expectantly and had a follow-up CL measurement within 3 weeks were included. Delivery data were obtained from the patients' computerized medical records.

Results: Sixty-eight patients met the inclusion criteria. 37% of the patients had a shorter CL on the second measurement. These patients delivered at an earlier gestational age (36+4 vs. 38+2 weeks, P=0.031) and were more likely to deliver at <37 weeks (60% vs. 26%, P=0.009). The change in the CL correlated with earlier gestational age at delivery and delivery at <37 weeks.

Conclusion: In patients diagnosed with a short cervix, follow-up CL measurement is a strong predictor of preterm delivery. Greater change in the CL correlates with an earlier gestational age at delivery. In the patient diagnosed with a short cervix, a repeat measurement of CL gives additional predictive value.