Miscarriage Research Today is a free monthly online journal that collates and summarizes the latest research about Miscarriage, including details on signs, symptoms, recurrent, pregnancy.

Risk factors for cervical insufficiency after term delivery.

Vyas NA, Vink JS, Ghidini A, Pezzullo JC, Korker V, Landy HJ, Poggi SH

Department of Obstetrics and Gynecology, Georgetown University Hospital, Washington, DC 20007, USA. nvyas99@yahoo.com

OBJECTIVE: Cervical insufficiency can be unexpected in a woman with a previous term birth. Our objective was to determine what risk factors, if any, place women with a term delivery at risk for cervical insufficiency in a subsequent pregnancy. STUDY DESIGN: Demographic characteristics were collected for a cohort of women with at least 1 previous term birth followed by cervical insufficiency (subject group) and for uncomplicated multiparous women (control group). Multiparous women with cervical insufficiency (subjects; n = 49) were compared with multiparous women who were experiencing repeat term birth with no history of cervical insufficiency (control group; n = 49). RESULTS: Patients with cervical insufficiency were similar to control subjects demographically. No difference was noted in previous cervical procedures or spontaneous preterm deliveries. Multivariate logistic regression analysis identified a history of curettage (odds ratio, 4.6; 95% CI, 1.7-12.5), precipitous delivery (odds ratio, 6.8; 95% CI, 1.6-29.6), and prolonged second stage of labor (odds ratio, 24.9; 95% CI, 2.4-253) as independent predictors of cervical insufficiency. CONCLUSION: Multiparous women who experience cervical insufficiency after a term birth are more likely to have had a previous precipitous delivery, a prolonged second stage of labor, or a previous curettage compared with multiparous women who experience a repeat term birth with no cervical insufficiency.

Published 4 September 2006 in Am J Obstet Gynecol, 195(3): 787-91.
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