Inpatient management for a shortened cervix: who is really at risk?

Overview

OBJECTIVE: The objective of the study was to identify risk factors associated with spontaneous preterm delivery (SPD) within 2 weeks of admission in patients with a shortened cervix. STUDY DESIGN: We reviewed records of patients hospitalized in 2003-2004 with a cervix of 25 mm or less at less than 32 weeks' gestation. The primary outcome was SPD 2 weeks or less of admission. RESULTS: Sixty-six patients met inclusion criteria. Twelve delivered at 2 weeks or less of admission. There were no differences in maternal and gestational age at admission, history of SPD, and rate of multifetal pregnancy. Those with cervical length (CL) of 5 mm or less were more likely to deliver within 2 weeks than those with CLs 6-25 mm (50% vs 12.5%; P = .01). Logistic regression identified CL less than 5 mm as the only independent predictor of delivery within 2 weeks of admission (P = .01). CONCLUSION: CL of less than 5 mm in patients at less than 32 weeks' gestation is associated with a high rate of SPD within 2 weeks of diagnosis.