Pregnancy outcomes in women with a surgically short cervix with no history of preterm birth

Abstract

Aims
Preterm birth is the leading cause for potentially lifelong morbidity and neonatal death. This study explores pregnancy outcomes for women with a surgically short cervix and no history of preterm birth.

Methods
This was a single-centre prospective cohort study including 144 patients who attended a specialist preterm birth clinic in a tertiary referral maternity hospital between 2019 and 2023. Inclusion criteria were significant cervical surgical history and no history of preterm birth.

Results
Among women with prior significant cervical surgical, those with a short cervical length (n=8/40, 20%) had a higher rate of preterm birth than women with a normal cervical length (n=7/104, 7%). Women with a short cervical length who had received a transabdominal cerclage were less likely to experience preterm birth (n=0/18, 0%) than if they did not have a transabdominal cerclage (n=5/22, 23%). Women with a normal cervical length could safely be managed conservatively.

Conclusion
Women with a short cervical length and no history of preterm birth may benefit from transabdominal cerclage. Where there is a history of significant cervical surgery but the cervical length remains normal, there is a high chance of a term birth. This study provides reassuring data to help counsel patients effectively.