Article

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.

0 Followers
 · 
204 Views
  • Source
    • "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. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Placenta previa poses a high risk for massive hemorrhage, from the antenatal period until after Cesarean section. This condition increases the risk of maternal and neonatal mortality and morbidity. In cases of placenta previa, the prenatal prediction of sudden bleeding during pregnancy and blood loss during Cesarean section, and the assessment of risk for adherence of the placenta using an ultrasound examination, can improve the perinatal outcome. Therefore, ultrasonographic findings associated with the prediction of massive bleeding in cases of placenta previa are reviewed in this article.
    Taiwanese journal of obstetrics & gynecology 03/2012; 51(1):3-6. DOI:10.1016/j.tjog.2012.01.002 · 1.26 Impact Factor
  • Source
    Ultrasound in Obstetrics and Gynecology 08/2009; 34(2):123-6. DOI:10.1002/uog.7312 · 3.14 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A short cervix in the second trimester is a powerful predictor of preterm birth risk. Multiple cervical length screens for patients in midpregnancy will likely become the standard of obstetrical care as a result of the development of effective methods (eg, cerclage, progesterone) to prevent early delivery in patients with a short cervix. Because of the high cost and infrastructure requirements, providing multiple cervical length evaluations through transvaginal ultrasound will likely be a significant barrier to universal screening. A cost-effective, low-technology method of cervical length screening is necessary to implement such programs. Available data suggest that digital examination is not sufficiently sensitive and reproducible to reliably screen for short cervix in presymptomatic patients in the mid trimester. New modalities for nonsonographic cervical length assessment (ie, Cervilenz) provide for a cost-effective, sensitive, and reproducible method of screening patients for short cervical length, which deserves further research in comparing its efficacy to sonographic cervical length.
    Seminars in perinatology 10/2009; 33(5):312-6. DOI:10.1053/j.semperi.2009.06.004 · 2.42 Impact Factor
Show more

Preview

Download
0 Downloads