October 4, 2001 – A study1 published in the Journal of the American Medical Association (JAMA) has just established a link between the length of the cervix and the incidence of giving birth prematurely. An ultrasound of the cervix performed between the 16e and the 18e week of pregnancy could help detect women at risk.
The research is important considering that preterm deliveries are one of the main perinatal health problems in industrialized countries (nearly 10% of women give birth before their 37th birthday).e week of pregnancy) which have serious consequences for the health of preterm children: neurological developmental disorders, chronic respiratory disorders, susceptibility to infections, ophthalmological problems, etc.
The double-blind study involved 183 women who had already given birth preterm. Researchers found that women whose collars were less than an inch tall, 16e at the 18e week, were three times more at risk of prematurity than women with normal cervical lengths. A collar is usually 1.5 inches in length; it lengthens during pregnancy to protect the fetus and narrows significantly during the preparatory phase of childbirth.
Dr Catherine Spong of the National Institute of Child Health and Human Development says this is “one of the first times that we have been able to find a method capable of detecting high-risk cases very early in pregnancy.” While technology now allows babies to survive an extremely early birth, Spong points out “that no preventive measure has been studied for the past twenty years.”
Further research is also needed to determine whether the new data apply to all pregnant women, since the current study only included women who had previously given birth prematurely.
The cause of most premature births is still unknown. However, it appears that a preventive intervention such as cervical cerclage is an avenue to be explored. Cerclage is a minor surgical operation that involves tightening the cervix by performing a circular ligature. This process could prove to be effective in delaying or preventing prematurity. Although this option has not yet been rigorously studied, there is case evidence that has demonstrated very good results.2.
Monique Lalancette – PasseportSanté.net
According to AP and InteliHealth September 19, 2001.
1. Owen J, Yost N, Berghella V, Thom E, Swain M, Dildy GA 3rd, Miodovnik M, Langer O, Sibai B, McNellis D; National Institute of Child Health and Human Development, Maternal-Fetal Medicine Units Network. Mid-trimester endovaginal sonography in women at high risk for spontaneous preterm birth. JAMA 2001 Sep 19; 286 (11): 1340-8.
2. Matijevic R, Olujic B, Tumbri J, Kurjak A. Cervical incompetence: the use of selective and emergency cerclage.. J Perinat Med 2001; 29 (1): 31-5.
