Diagnosis of short cervix in a community hospital prior to placement of a therapeutic cerclage

Am J Perinatol. 2007 Sep;24(8):457-60. doi: 10.1055/s-2007-986685.


The purpose of this study was to describe how obstetricians in the community define a short cervix prior to cerclage placement. A secondary analysis of cerclages placed for the diagnosis of short cervix, defined by either digital or ultrasound examination, were identified from a cohort of 1076 cerclages placed at a community hospital from January 1, 2000, through December 31, 2004. Two hundred twenty-six cerclages were placed for the diagnosis of short cervix. Fifty-eight women (25.7%) were nulliparous. The mean estimated gestational age at placement was 15.4 +/- 3.8 weeks. More than half of the cerclages (n = 125; 55.3%) were placed prior to 15 weeks estimated gestational age. Of those cases with documented cervical length by ultrasound (n = 171), 36 of these patients (21.1%) had a cervical length of > or = 25 mm. The most common indications for cerclage placement were short cervix only (40.3%), previous cone biopsy/loop electrocautery excision procedure (28.8%), and multiple gestation (9.7%). In a community hospital, cerclages for short cervix are often performed in nulliparous women without antecedent risk factors at a gestational age when cervical length is not a reliable tool for predicting adverse pregnancy outcome.

MeSH terms

  • Adult
  • Cerclage, Cervical / methods*
  • Cervical Length Measurement / methods*
  • Cervix Uteri / anatomy & histology*
  • Female
  • Hospitals, Community
  • Humans
  • Pregnancy
  • Premature Birth / prevention & control
  • Retrospective Studies