Prognosis in cervical insufficiency at less than 32 weeks of gestation

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• 作者：Minoru Mitani ; Yoshio Matsuda ; Erina Ono ; Yoshika Akizawa and Hiroaki Ohta
• 刊名：European Journal of Obstetrics and Gynecology and Reproductive Biology
• 出版年：2006
• 出版时间：1 March 2006
• 年：2006
• 卷：125
• 期：1
• 页码：34-37
• 全文大小：90 K

文摘

Objective

To identify prenatal events associated with adverse outcome in babies at less than 32 weeks of gestation in cases of cervical insufficiency and preterm labor (PTL)/premature rupture of the membranes (PROM).

Study design

A case-control study was performed using a logistic regression model at 17 tertiary hospitals in Japan. Adverse outcome was defined as neonatal death or abnormal cerebral ultrasound scans (intraventricular hemorrhage [IVH] and periventricular leukomalacia [PVL]) prior to discharge from hospital.

Results

Data were analyzed for 307 cases (74 for cervical insufficiency and 233 for PTL/PROM). Neonatal death and IVH/PVL were noted in 25 and 29 cases, respectively. A significant association of cervical insufficiency (odds ratio (OR) 1.32, 95 % confidence interval (CI) 1.02–1.68), gestational age at delivery (<26 weeks) (OR 4.64, 95 % CI 1.73–12.44), and Apgar score <7 at 5 min (OR 3.3, 95 % CI 1.42–7.64) with combined neonatal death or IVH and PVL was found in a logistic regression model that controlled for in utero transportation, gestational age on admission, clinical chorioamnionitis, and histopathologic chorioamnionitis.

Conclusion

Cervical insufficiency is a significant factor related to the occurrence of adverse outcome.