Women With Long Cervixes Mid-Pregnancy Have Higher C-Section Risk, NEJM Study Finds

Main Category: Pregnancy / Obstetrics
Article Date: 01 Apr 2008 - 8:00 PDT

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Pregnant women who have long cervixes midway through pregnancy are more likely to need an emergency caesarean section during childbirth, according to a study published Thursday in the New England Journal of Medicine, Reuters reports (Emery, Reuters, 3/27).

Researchers from Cambridge University and King's College School of Medicine used transvaginal ultrasounds to measure the cervixes of more than 27,000 women who were pregnant for the first time (O'Leary, West Australian, 3/28). About one-quarter of women whose cervixes measured from 40 millimeters to 67 mm between 22 and 24 weeks' gestation had an emergency c-section. This compares with 21.7% of women whose cervixes measured 36 mm to 39 mm, 18.4% of women whose cervixes measured 31 mm to 35 mm and 16% of women whose cervixes measured 16 mm to 30 mm (Reuters, 3/27). Women with the longest cervical measurements had an 80% increased risk of a c-section than those with the shortest lengths, according to the study (HealthDay/Atlanta Journal-Constitution, 3/26).

The findings "suggest that cervical length at mid-pregnancy is an important indicator of the risk of primary [c-section] delivery at term," the researchers said (Reuters, 3/27). Miriam Greene, an obstetrician at the New York University Medical Center, said the study "makes sense" because if the "cervix hasn't prepped itself for labor, there's something going on." She added, "The question is, if I start checking at 23 weeks and find a longer cervix, what then?" Study leader Gordon Smith, head of obstetrics and gynecology at Cambridge University, said women do not need to have their cervical lengths measured to "predict" their risk of a c-section. "The key issue in this analysis is understanding the processes that lead to normal and abnormal labor," Smith said (HealthDay/Atlanta Journal-Constitution, 3/26).

An abstract of the study is available online.

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