Uterine fibroids at routine second-trimester ultrasound survey and risk of sonographic short cervix
J Matern Fetal Neonatal Med
OBJECTIVE: To determine whether women with sonographically identified uterine fibroids are at higher risk for a short cervix. METHODS: This retrospective cohort study evaluated all women with singleton gestations who had a routine second-trimester ultrasound at 17-23 weeks gestational age from 2010-2013. When fibroids were noted, their presence, number, location and size were recorded. Exclusion criteria included a history of cervical conization or loop electrosurgical excision procedure (LEEP), uterine anomalies, maternal age greater than 40 years, and a previously placed cerclage. The primary variable of interest was short cervix (<25 >mm). Secondary variables of interest included gestational age at delivery, mode of delivery, indication for cesarean, malpresentation, birth weight and Apgar scores. A multivariable logistic regression analysis was performed. RESULTS: Fibroids were identified in 522/10,314 patients (5.1%). In the final multivariable logistic regression model, short cervix was increased in women with fibroids (OR 2.29, 95% CI: 1.40, 3.74). The number of fibroids did not affect the frequency of short cervix. Fibroids were significantly associated with preterm delivery (<37 >weeks), primary cesarean, breech presentation, lower birth weight infants and lower Apgar scores. CONCLUSIONS: Women with uterine fibroids may be at higher risk for a short cervix. Fibroids are also associated with several adverse obstetric and neonatal outcomes.
Faculty; Northwell Researcher
School of Medicine; Northwell Health
Obstetrics and Gynecology