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Am J Perinatol. 2010 Jan;27(1):37-40. doi: 10.1055/s-0029-1236437. Epub 2009 Aug 14.

The patient with asymptomatic shortened cervix at 23 to 28 weeks: is delivery imminent?

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Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York 10032, USA.


We investigated whether the presence of symptoms predicts the timing of subsequent spontaneous preterm birth in a cohort of women with cervical length (CL) <1.5 cm. A retrospective cohort study was conducted that included patients from 23 to 28 weeks' gestation with a CL <1.5 cm on routine ultrasound. Two groups were defined on the basis of presenting symptoms at the time of the ultrasound examination: asymptomatic patients and those with symptoms of preterm labor. The incidence of delivery within 2 weeks was determined for both groups. A total of 88 patients with CL <1.5 cm were identified from an ultrasound database. There were 52 patients with CL <1.5 cm and no symptoms. Of these, 1 (1.9%) delivered within 2 weeks. The remaining 36 patients had a CL <1.5 cm and symptoms of preterm labor. Of these, 11 (30.6%) delivered within 2 weeks (relative risk 15.9, 95% confidence interval 2.1 to 118). Premature cervical shortening at 23 to 28 weeks, in the absence of symptoms of preterm labor, is rarely associated with preterm delivery within 2 weeks. Following those patients clinically may prevent prolonged hospitalization and allow steroid administration closer to the date of delivery.

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