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43: Sonographic cervical length and hemorrhage in women with placenta previa

      Objective

      To determine if there was an association between sonographic cervical length and hemorrhage leading to preterm delivery in women with placenta previa.

      Study Design

      Between October 2007 and May 2009, transvaginal cervical length measurements were prospectively measured in all women with singleton pregnancies and placenta previa identified during ultrasound examination 24 weeks. Only women who delivered liveborn or stillborn infants at our hospital and who had previa confirmed at delivery were included. A cervical length 30 mm was considered short and clinicians were blinded to cervical measurements. Chi-square and logistic regression were used for analysis.

      Results

      Of 105 identified women, 68 had confirmed placenta previa at delivery: 29 (42%) had cervical length 30mm and the remaining were > 30 mm. Gestational age at cervical length measurement was 32.2 +/−4 and 32.9+/−2 weeks respectively, P = 0.44. Women with previa and short cervix were more likely to require delivery for hemorrhage (79% v. 28%, P <0.001) and to deliver preterm (69% v. 21%, P < 0.001). Reports of uterine contractions as well as contractions during tocodynamometry were significantly more common in women with a short cervix (55% v. 13% and 69% v. 21%, respectively, P <0.001). Conversely, 72% of women with cervical length > 30 mm had no bleeding episodes and underwent elective cesarean delivery for placenta previa at term.

      Conclusion

      Sonographic short cervical length was associated with hemorrhage, uterine contractions, and preterm birth in women with placenta previa.
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