Indian Journal of Public Health Research & Development

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Cervical Length and Risk of Hemorrhage in Pregnancies with Placenta Previa


Affiliations
1 Department of Obstetrics and Gynecology, L.L.R.M. Medical College, Meerut, India
2 Department of Obstetrics and Gynecology, L.L.R.M. Medical College, Meerut, UP, India
3 Department of Obstetrics and Gynecology, L.L.R.M. Medical College, Meerut, UP, India
     

   Subscribe/Renew Journal


Aim: To find out the relationship between ultrasonographic cervical length and risk of antepartum hemorrhage, preterm delivery and emergency caesarean section in pregnancies with placenta previa.

Material and Methods: We performed transvaginal cervical-length measurements on all singleton gestations with placenta previa admitted in our hospital at or beyond 24 weeks of gestation over a span of one year. A complete follow-up of pregnancy was obtained in all cases till delivery and a retrospective chart review was then performed for these cases to investigate the relationship between cervical length and maternal and neonatal outcome.

Results: Overall 70 patients comprised the study, in whom placenta previa persisted till delivery. Cervical length measurement was 30 mm in 43 (61.4%) cases. Cervical length ranged from 20 to 50 mm with a mean of 35.6±0.90 mm. Majority of subjects (51.9%) in whom measurements were done between 28-32 weeks had cervical length 30 mm. The association between gestational age and cervical length was statistically significant.

Conclusion: In pregnancies with placenta previa, a third-trimester transvaginal sonographic cervical length of 30 mm or less is associated with increased risk for hemorrhage, emergency caesarean section and preterm birth.


Keywords

Placenta Previa, Antepartum Hemorrhage, Transvaginal Sonography, Cervical Length
Subscription Login to verify subscription
User
Notifications
Font Size


  • Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Obstetrical hemorrhage, Williams obstetrics, 23rd ed. New York (NY): McGraw-Hill; 2009, p.769–73.

  • Crane JM, Van den Hof MC, Dods L, Armson BA, Liston R. Neonatal outcomes with placenta previa. Obstet Gynecol 1997;177:210–4.

  • Ananth CV, Smulian JC, Vintzileos AM. The effect of placenta previa on neonatal mortality: a population-based study in the United States, 1989 through 1997. Am J Obstet Gynecol 2003;188:1299–304.

  • Iams JD, Goldenberg RL, Meis PJ, et al. The length of the cervix and the risk of spontaneous premature delivery. National Institute of Child Health and Human Development Maternal Fetal Medicine Unit Network. N Engl J Med 1996;334:567–72.

  • Owen J, Yost N, Berghella V, et al. Mid-trimester endovaginal sonography in women at high risk for spontaneous preterm birth. JAMA 2001;286:1340–8.

  • Dashe JS, McIntire DD, Ramus RM, Santos- Ramos R, Twickler DM. Persistence of placenta previa according to gestational age at ultrasound detection. Obstet Gynecol 2002;99:692–7.

  • Rozenberg P, Gillet A, Ville Y. Transvaginal sonographic examination of the cervix in asymptomatic pregnant women: review of the literature. Ultrasound Obstet Gynecol 2002; 19: 302–311.

  • Palacio M, Sanin-Blair J, S´anchez M, et al. The use of a variable cut-off value of cervical length in women admitted for preterm labour before and after 32 weeks. Ultrasound Obstet Gynecol 2007; 29: 421–426.

  • Oyelese Y, Smulian JC. Placenta praevia, placenta accreta, and vasa praevia. Obstet Gynecol 2006; 107: 927–941.


Abstract Views: 327

PDF Views: 3




  • Cervical Length and Risk of Hemorrhage in Pregnancies with Placenta Previa

Abstract Views: 327  |  PDF Views: 3

Authors

Urmila Karya
Department of Obstetrics and Gynecology, L.L.R.M. Medical College, Meerut, India
Khushboo Varma
Department of Obstetrics and Gynecology, L.L.R.M. Medical College, Meerut, India
Shakun Singh
Department of Obstetrics and Gynecology, L.L.R.M. Medical College, Meerut, UP, India
Abhilasha Gupta
Department of Obstetrics and Gynecology, L.L.R.M. Medical College, Meerut, UP, India

Abstract


Aim: To find out the relationship between ultrasonographic cervical length and risk of antepartum hemorrhage, preterm delivery and emergency caesarean section in pregnancies with placenta previa.

Material and Methods: We performed transvaginal cervical-length measurements on all singleton gestations with placenta previa admitted in our hospital at or beyond 24 weeks of gestation over a span of one year. A complete follow-up of pregnancy was obtained in all cases till delivery and a retrospective chart review was then performed for these cases to investigate the relationship between cervical length and maternal and neonatal outcome.

Results: Overall 70 patients comprised the study, in whom placenta previa persisted till delivery. Cervical length measurement was 30 mm in 43 (61.4%) cases. Cervical length ranged from 20 to 50 mm with a mean of 35.6±0.90 mm. Majority of subjects (51.9%) in whom measurements were done between 28-32 weeks had cervical length 30 mm. The association between gestational age and cervical length was statistically significant.

Conclusion: In pregnancies with placenta previa, a third-trimester transvaginal sonographic cervical length of 30 mm or less is associated with increased risk for hemorrhage, emergency caesarean section and preterm birth.


Keywords


Placenta Previa, Antepartum Hemorrhage, Transvaginal Sonography, Cervical Length

References