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What is predictive of preterm delivery in the first trimester: isthmus or cervical length?
Author(s) -
Sananès Nicolas,
Schuller Elodie,
Gaudineau Adrien,
Kohler Monique,
Guerra Fernando,
Weingertner AnneSophie,
Fritz Gabrielle,
Viville Brigitte,
Langer Bruno,
Nisand Israël,
Favre Romain
Publication year - 2013
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4158
Subject(s) - medicine , cervix , preterm delivery , obstetrics , first trimester , ultrasonography , ultrasound , second trimester , pregnancy , gynecology , surgery , gestation , radiology , biology , cancer , genetics
Objective This study aims to evaluate the utility of first trimester cervical ultrasonography in predicting preterm delivery by separate analysis of measurements of cervical and isthmus length. Methods This is a cohort study based on data collected prospectively on singletons between 1 July 2011 and 1 February 2013. Mean cervical, isthmus and cervico‐isthmic complex length were measured for deliveries before and after 37 weeks. Results A total of 1494 pregnancies were analysed, including 51 cases of spontaneous preterm delivery (3.4%). The cervico‐isthmic complex in the first trimester was significantly shorter in patients who delivered before term (43.8 mm vs 47.5 mm, p = 0.04). This difference is related to differences in length at the isthmus (10.7 mm vs 14.1 mm, p = 0.005) rather than at the cervix proper (34.5 mm vs 35.0 mm, p = 0.56). Conclusions Measurement of the cervico‐isthmic complex enables detection of a number of patients who will go on to deliver before term. Further studies are necessary to confirm that isthmic length and not cervical length is predictive of preterm delivery. © 2013 John Wiley & Sons, Ltd.