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Acta Obstet Gynecol Scand. 2017 Aug;96(8):984-990. doi: 10.1111/aogs.13143. Epub 2017 May 16.

Cervical collagen is reduced in non-pregnant women with a history of cervical insufficiency and a short cervix.

Author information

1
Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.
2
Clinic of Obstetrics and Gynecology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark.
3
Department of Obstetrics and Gynecology, The Regional Hospital Horsens, Horsens, Denmark.

Abstract

INTRODUCTION:

Preterm cervical shortening and cervical insufficiency may be caused by a constitutional weakness of the cervix. The aim of this study was to assess the cervical collagen concentration in non-pregnant women with a history of cervical insufficiency or of a short cervix in the second trimester of pregnancy.

MATERIAL AND METHODS:

In this case-control study we included non-pregnant women one year or more after pregnancy: 55 controls with a history of normal delivery; 27 women with a history of cervical insufficiency; and 10 women with a history of a short cervix (<5th percentile) and 10 women with a history of a long cervix (>95th percentile) at gestational weeks 18-20. We obtained biopsies (3 × 3-4 mm) from the ectocervix and determined the collagen concentration by measuring the hydroxyproline concentration.

RESULTS:

Women with cervical insufficiency had lower collagen concentrations (63.5 ± 5.1%; mean ± SD) compared with controls (68.2 ± 5.4%; p = 0.0004); area under the ROC curve 0.73 (95% CI 0.62-0.84). A cut-off value at 67.6% collagen resulted in a positive likelihood ratio of 3.2, a sensitivity of 60%, and a specificity of 81%. Also, women with a short cervix in the second trimester had lower collagen concentrations in a non-pregnant state (62.1% ± 4.9%) compared with women with a long cervix (67.8% ± 5.0%; p = 0.02).

CONCLUSIONS:

Both cervical insufficiency and a short cervix in the second trimester of pregnancy are associated with low cervical collagen concentrations in a non-pregnant state more than one year after pregnancy.

KEYWORDS:

Uterine cervix; cervical incompetence; cervical insufficiency; cervical length; collagen; hydroxyproline; prematurity; preterm birth

PMID:
28374904
DOI:
10.1111/aogs.13143
[Indexed for MEDLINE]

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