Cervical length and risk of antepartum bleeding in women with complete placenta previa

Department of Obstetrics and Gynecology, University Hospital of Bologna, Bologna, Italy.
Ultrasound in Obstetrics and Gynecology (Impact Factor: 3.14). 02/2009; 33(2):209-12. DOI: 10.1002/uog.6301
Source: PubMed

ABSTRACT To evaluate if cervical length predicts prepartum bleeding and emergency Cesarean section in cases of placenta previa.
Between September 2005 and September 2007, cervical length was measured by transvaginal ultrasound in women with complete placenta previa persisting into the third trimester of pregnancy. A complete follow-up of pregnancy was obtained in all cases.
Overall, 59 women were included in the study group. The mean +/- SD gestational age at ultrasound was 30.7 +/- 2.7 weeks and the cervical length was 36.9 +/- 8.8 mm. Cesarean delivery was performed in all cases, at a mean gestational age of 34.7 +/- 2.3 weeks. Twenty-nine (49.1%) of the women presented prepartum bleeding and 12 (20.3%) required an emergency Cesarean section prior to 34 completed weeks due to massive hemorrhage. Cervical length did not differ significantly between cases with and those without prepartum bleeding (35.3 +/- 9.3 mm vs. 38.4 +/- 8.2 mm; P = 0.18), but was significantly shorter among patients who underwent emergency Cesarean section < 34 weeks due to massive hemorrhage compared with patients who underwent elective Cesarean section (29.4 +/- 5.7 mm vs. 38.8 +/- 8.5 mm; P = 0.0006).
Transvaginal sonographic cervical length predicts the risk of emergency Cesarean section < 34 weeks in women with complete placenta previa.

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    • "It is common practice to measure the cervical length using transvaginal ultrasound to predict preterm delivery. It is interesting to note that Ghi et al reported a possible association between the cervical length and the risk of preterm hemorrhage in patients with complete placenta previa [5]. Although the cervical length did not differ significantly between cases with and without prepartum bleeding, it was significantly shorter among patients who underwent an emergency Cesarean section at <34 weeks, due to massive hemorrhage compared with patients who underwent an elective Cesarean section. "
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