Research Article
The Role of Cervical Length Measurement In Predicting The Need For Hysterectomy In Patients With Placenta Previa
Abstract
Objective: To determine the association of cervical length with the need for peripartum hysterectomy in patients with placenta previa
Method: Patients with placenta previa totalis, which performed in 2021, were included in the study. Cervical length was measured by transvaginal technique after 28 weeks. ROC analysis was performed for the cervical length variable in patients requiring peripartum hysterectomy.
Results: Peripartum hysterectomy was performed in 26 out of 66 patients (39.4%). When ROC analysis was performed for cervical length in these patients, AUC was 0.999 (95% confidence interval 0.994-0.999) when the cut-off point was ≤26.5.
Conclusion: The risk of peripartum hysterectomy increases as cervical length shortens.
References
- Jauniaux E, Bhide A. Prenatal ultrasound diagnosis and outcome of placenta previa accreta after cesarean delivery: a systematic review and meta-analysis. Am J Obstet Gynecol. 2017;217(1):27-36. http://doi:10.1016/j.ajog.2017.02.050
- Cresswell JA, Ronsmans C, Calvert C, Filippi V. Prevalence of placenta praevia by world region: a systematic review and meta-analysis. Trop Med Int Health. 2013;18(6):712-24. http://doi:10.1111/tmi.12100
- Mitsuzuka K, Togo A, Nakajima R, Kanno Y, Sato K, Ishimoto H. Is Cervical Length a Useful Predictor of Antepartum Hemorrhage in Patients with Placenta Previa?. Tokai J Exp Clin Med. 2022;47(4):204-8.
- Crane JM, Van den Hof MC, Dodds L, Armson BA, Liston R. Maternal complications with placenta previa. Am J Perinatol. 2000;17(2):101-5. http://doi:10.1055/s-2000-9269
- 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(9):567-72. http://doi:10.1056/NEJM199602293340904
- Silver RM, Landon MB, Rouse DJ, et al. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol. 2006;107(6):1226-32. http://doi:10.1097/01.AOG.0000219750.79480.84
- Califano G, Saccone G, Maria Maruotti G, et al. Prenatal identification of invasive placentation using ultrasound in women with placenta previa and prior cesarean delivery. Eur J Obstet Gynecol Reprod Biol. 2024;302:97-103. http://doi:10.1016/j.ejogrb.2024.08.035
- Hessami K, Mitts M, Zargarzadeh N, Jamali M, Berghella V, Shamshirsaz AA. Ultrasonographic cervical length assessment in pregnancies with placenta previa and risk of perinatal adverse outcomes: a systematic review and meta-analysis. Am J Obstet Gynecol MFM. 2024;6(5S):101172. http://doi:10.1016/j.ajogmf.2023.101172
- Mimura T, Hasegawa J, Nakamura M, et al. Correlation between the cervical length and the amount of bleeding during cesarean section in placenta previa. J Obstet Gynaecol Res. 2011;37(7):830-5. http://doi:10.1111/j.1447-0756.2010.01446.x
- Dang X, Fan C, Cui F, et al. Interactions between ultrasonographic cervical length and placenta accreta spectrum on severe postpartum hemorrhage in women with placenta previa. Int J Gynaecol Obstet. 2023;161(3):1069-74. http://doi:10.1002/ijgo.14641
- Zheng X, Li T, Zeng M, Cheng X, Rao H. The clinical value of prenatal assessment of cervical length and placental thickness in pregnant women with placenta previa. Am J Transl Res. 2021;13(5):5308-14.
- Zhou L, Zhao X, Xu D, et al. Placental Area in the Lower Uterine Segment, Cervical Length, and Clinical Outcome in Pregnancies With Complete Placenta Previa. J Magn Reson Imaging. 2023;58(4):1047-54. http://doi:10.1002/jmri.28617
- Polat M, Kahramanoglu I, Senol T, Ozkaya E, Karateke A. Shorter the cervix, more difficult the placenta percreta operations. J Matern Fetal Neonatal Med. 2016;29(14):2327-31. http://doi:10.3109/14767058.2015.1085017
- Society for Maternal-Fetal Medicine (SMFM). Electronic address: pubs@smfm.org, McIntosh J, Feltovich H, Berghella V, Manuck T. The role of routine cervical length screening in selected high- and low-risk women for preterm birth prevention. Am J Obstet Gynecol. 2016;215(3):B2-B7. http://doi:10.1016/j.ajog.2016.04.027
Year 2025,
Volume: 16 Issue: 54, 33 - 37, 12.04.2025
Abstract
References
- Jauniaux E, Bhide A. Prenatal ultrasound diagnosis and outcome of placenta previa accreta after cesarean delivery: a systematic review and meta-analysis. Am J Obstet Gynecol. 2017;217(1):27-36. http://doi:10.1016/j.ajog.2017.02.050
- Cresswell JA, Ronsmans C, Calvert C, Filippi V. Prevalence of placenta praevia by world region: a systematic review and meta-analysis. Trop Med Int Health. 2013;18(6):712-24. http://doi:10.1111/tmi.12100
- Mitsuzuka K, Togo A, Nakajima R, Kanno Y, Sato K, Ishimoto H. Is Cervical Length a Useful Predictor of Antepartum Hemorrhage in Patients with Placenta Previa?. Tokai J Exp Clin Med. 2022;47(4):204-8.
- Crane JM, Van den Hof MC, Dodds L, Armson BA, Liston R. Maternal complications with placenta previa. Am J Perinatol. 2000;17(2):101-5. http://doi:10.1055/s-2000-9269
- 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(9):567-72. http://doi:10.1056/NEJM199602293340904
- Silver RM, Landon MB, Rouse DJ, et al. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol. 2006;107(6):1226-32. http://doi:10.1097/01.AOG.0000219750.79480.84
- Califano G, Saccone G, Maria Maruotti G, et al. Prenatal identification of invasive placentation using ultrasound in women with placenta previa and prior cesarean delivery. Eur J Obstet Gynecol Reprod Biol. 2024;302:97-103. http://doi:10.1016/j.ejogrb.2024.08.035
- Hessami K, Mitts M, Zargarzadeh N, Jamali M, Berghella V, Shamshirsaz AA. Ultrasonographic cervical length assessment in pregnancies with placenta previa and risk of perinatal adverse outcomes: a systematic review and meta-analysis. Am J Obstet Gynecol MFM. 2024;6(5S):101172. http://doi:10.1016/j.ajogmf.2023.101172
- Mimura T, Hasegawa J, Nakamura M, et al. Correlation between the cervical length and the amount of bleeding during cesarean section in placenta previa. J Obstet Gynaecol Res. 2011;37(7):830-5. http://doi:10.1111/j.1447-0756.2010.01446.x
- Dang X, Fan C, Cui F, et al. Interactions between ultrasonographic cervical length and placenta accreta spectrum on severe postpartum hemorrhage in women with placenta previa. Int J Gynaecol Obstet. 2023;161(3):1069-74. http://doi:10.1002/ijgo.14641
- Zheng X, Li T, Zeng M, Cheng X, Rao H. The clinical value of prenatal assessment of cervical length and placental thickness in pregnant women with placenta previa. Am J Transl Res. 2021;13(5):5308-14.
- Zhou L, Zhao X, Xu D, et al. Placental Area in the Lower Uterine Segment, Cervical Length, and Clinical Outcome in Pregnancies With Complete Placenta Previa. J Magn Reson Imaging. 2023;58(4):1047-54. http://doi:10.1002/jmri.28617
- Polat M, Kahramanoglu I, Senol T, Ozkaya E, Karateke A. Shorter the cervix, more difficult the placenta percreta operations. J Matern Fetal Neonatal Med. 2016;29(14):2327-31. http://doi:10.3109/14767058.2015.1085017
- Society for Maternal-Fetal Medicine (SMFM). Electronic address: pubs@smfm.org, McIntosh J, Feltovich H, Berghella V, Manuck T. The role of routine cervical length screening in selected high- and low-risk women for preterm birth prevention. Am J Obstet Gynecol. 2016;215(3):B2-B7. http://doi:10.1016/j.ajog.2016.04.027
There are 14 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Obstetrics and Gynaecology |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | April 12, 2025 |
| Submission Date | December 17, 2024 |
| Acceptance Date | March 11, 2025 |
| Published in Issue | Year 2025 Volume: 16 Issue: 54 |