"A million-plus induced abortions are performed in the U.S. alone each year. Some studies have demonstrated an increased risk of pre-term birth in women who have had induced abortions," according to lead researcher Dr. Jacquelyn Pelham from Thomas Jefferson University in Philadelphia. Pre-term birth is the leading cause of perinatal mortality, affecting 8% to 10% of births.
The investigators analyzed 43 women with a history of induced abortion by D&C at less than 12 weeks. Patients were prospectively studied with transvaginal cervical ultrasound (TVU) to determine cervical length (CL) between 14-24 weeks. The predictive value of TVU was evaluated using less than 25 mm CL as criteria for the diagnosis of a short cervix. The primary outcome was pre-term birth less than 35 weeks.
Of the 43 women evaluated, 22 (51%) had a short cervix. Of these, eight (36%) had pre-term birth of less than 35 weeks. Of the 21 patients without a short cervix, only two (10%) had a pre-term birth less than 35 weeks.
The researchers found a sensitivity of 80% for cervical TVU for pre-term birth less than 35 weeks. The specificity was 58%, the positive predictive value was 36%, and the negative predictive value was 90%. The relative risk was 3.8 (95% CI 0.9, 16).
"In this population of women already at risk for pre-term birth, we determined that TVU of the cervix is a useful predictor of pre-term birth," Pelham said. The results of this study may lead to increased use of transvaginal ultrasound (TVU) to evaluate a patient’s risk for pre-term birth, possibly allowing for earlier intervention. However, further research may be needed before such a global conclusion is drawn, she added.
By Jerry Ingram and Bruce SylvesterAuntMinnie.com contributing writers
July 4, 2003
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Ultrasound study links uterine fibroids to pregnancy loss, November 14, 2001
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