Cervical competence as a continuum: a study of ultrasonographic cervical length and obstetric performance
Abstract
Objective Our purpose was to investigate the hypothesis that cervical competence is a continuum that is related to cervical length and is reflected by pregnancy history.Study design A cross-sectional study was performed of cervical length measured by transvaginal ultrasonography in women with prior preterm delivery at < or = 26 weeks, 27 to 32 weeks, and 33 to 35 weeks compared with women with cervical incompetence and normal controls delivered at term.Results Transvaginal cervical length was measured during pregnancy in 32 subjects with cervical incompetence, 98 with previous preterm birth < or = 26 weeks, 98 with previous preterm birth at 27 to 32 weeks, 127 with previous preterm birth at 33 to 35 weeks, and 106 normal controls. The relationship between obstetric history and cervical length was evaluated by analysis of variance. The gestational age at the first preterm delivery was significantly correlated with cervical length in the current pregnancy at each gestational interval between 20 and 30 weeks in a continuous manner.Conclusion Cervical competence is a continuous rather than categoric variable and is indicated indirectly by measurement of the length of the cervix.
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Cervical insufficiency caused by congenital cervical weakness, surgery, or trauma has been implicated as causal for some preterm births, but its exact contribution to preterm birth is unknown.
“Cervical insufficiency caused by congenital cervical weakness, surgery, or trauma has been implicated as causal for some preterm births; however, distinguishing cervical insufficiency from cervical shortening attributable to other causes has proven difficult, and the exact contribution to preterm birth is unknown.125”
From Epidemiology and causes of preterm birth (2008) · cites this paper as [125]
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- Authors
- Iams, J. D., Johnson, F. F., Sonck, J., Sachs, L., Gebauer, C., & Samuels, P.
- Affiliations
- The Ohio State University (US)
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 1995-04
- Volume
- 172
- Issue
- 4
- Pages
- 1097-1106
- ISSN
- 0002-9378 (ISSN-L)
- OpenAlex
- W2041937082
- Cited by
- 294
- References
- 11
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 4 · 2023: 7 · 2022: 5 · 2021: 9 · 2020: 6 · 2019: 7 · 2018: 7 · 2017: 14 · 2016: 12 · 2015: 9 · 2014: 6 · 2013: 13 · 2012: 15
- FWCI
- 6.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Preterm Birth and Chorioamnionitis
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Keywords
- cervical length, transvaginal ultrasound, preterm birth, cervical incompetence, obstetric history, gestational age
- MeSH terms
- Adult, Analysis of Variance, Uterine Cervical Incompetence, Cervix Uteri, Cross-Sectional Studies, Female, Gestational Age, Humans, Obstetric Labor, Premature, Pregnancy, Pregnancy Outcome, Ultrasonography
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