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• W2065463911 abstract "To the Editors:I read with interest the work of Iams et al. (Iams JD, Johnson FF, Sonek J, Sachs L, Gebauer C, Samuels P. Cervical competence as a continuum: A study of ultrasonographic cervical length and obstetric performance. Am J Obstet Gynecol 1995;172:1097-106) and agree with their conclusion that cervical competence is a continuum. There are two points I would like to raise. First, as the authors discussed, the results may be complicated by the variable use of cerclage in each of the individual “reproductive history” groups. They report the differences in cervical length at each gestational age in the current pregnancy between women with or without cerclage. However, it would be interesting to know whether there was any difference in cervical length between the two groups (with or without cerclage) on the basis of “reproductive history.” In other words, did the 42% of women whose first preterm birth was delivered before 26 weeks and who did not undergo cerclage in the current pregnancy have any difference in cervical length measurements compared with the 58% who received a suture? Cervical change after cerclage has been demonstrated by several authors,1Andersen HF Karimi A Sakala EP Kalugdan R Prediction of cervical cerclage outcome by endovaginal ultrasonography.Am J Obstet Gynecol. 1994; 171: 1102-1106Abstract Full Text PDF PubMed Scopus (61) Google Scholar but what remains unclear is whether the operation actually prevents or reduces subsequent shortening. There is an obvious paucity of randomized trials comparing surgical with nonsurgical management in this situation. Second, a cervical length of ≤25 mm is commonly being quoted as the diagnostic criteria for a short cervix.2Iams JD Goldenberg RL Meis PJ et al.The length of the cervix and the risk of spontaneous prematurity.N Engl J Med. 1996; 334: 567-572Crossref PubMed Scopus (1512) Google Scholar I note that most of the “reproductive history” groups reached this cervical length at approximately the same gestational age in the current pregnancy as in their first preterm births, possibly implying an element of biologic timing.Response declined To the Editors:I read with interest the work of Iams et al. (Iams JD, Johnson FF, Sonek J, Sachs L, Gebauer C, Samuels P. Cervical competence as a continuum: A study of ultrasonographic cervical length and obstetric performance. Am J Obstet Gynecol 1995;172:1097-106) and agree with their conclusion that cervical competence is a continuum. There are two points I would like to raise. First, as the authors discussed, the results may be complicated by the variable use of cerclage in each of the individual “reproductive history” groups. They report the differences in cervical length at each gestational age in the current pregnancy between women with or without cerclage. However, it would be interesting to know whether there was any difference in cervical length between the two groups (with or without cerclage) on the basis of “reproductive history.” In other words, did the 42% of women whose first preterm birth was delivered before 26 weeks and who did not undergo cerclage in the current pregnancy have any difference in cervical length measurements compared with the 58% who received a suture? Cervical change after cerclage has been demonstrated by several authors,1Andersen HF Karimi A Sakala EP Kalugdan R Prediction of cervical cerclage outcome by endovaginal ultrasonography.Am J Obstet Gynecol. 1994; 171: 1102-1106Abstract Full Text PDF PubMed Scopus (61) Google Scholar but what remains unclear is whether the operation actually prevents or reduces subsequent shortening. There is an obvious paucity of randomized trials comparing surgical with nonsurgical management in this situation. Second, a cervical length of ≤25 mm is commonly being quoted as the diagnostic criteria for a short cervix.2Iams JD Goldenberg RL Meis PJ et al.The length of the cervix and the risk of spontaneous prematurity.N Engl J Med. 1996; 334: 567-572Crossref PubMed Scopus (1512) Google Scholar I note that most of the “reproductive history” groups reached this cervical length at approximately the same gestational age in the current pregnancy as in their first preterm births, possibly implying an element of biologic timing.Response declined I read with interest the work of Iams et al. (Iams JD, Johnson FF, Sonek J, Sachs L, Gebauer C, Samuels P. Cervical competence as a continuum: A study of ultrasonographic cervical length and obstetric performance. Am J Obstet Gynecol 1995;172:1097-106) and agree with their conclusion that cervical competence is a continuum. There are two points I would like to raise. First, as the authors discussed, the results may be complicated by the variable use of cerclage in each of the individual “reproductive history” groups. They report the differences in cervical length at each gestational age in the current pregnancy between women with or without cerclage. However, it would be interesting to know whether there was any difference in cervical length between the two groups (with or without cerclage) on the basis of “reproductive history.” In other words, did the 42% of women whose first preterm birth was delivered before 26 weeks and who did not undergo cerclage in the current pregnancy have any difference in cervical length measurements compared with the 58% who received a suture? Cervical change after cerclage has been demonstrated by several authors,1Andersen HF Karimi A Sakala EP Kalugdan R Prediction of cervical cerclage outcome by endovaginal ultrasonography.Am J Obstet Gynecol. 1994; 171: 1102-1106Abstract Full Text PDF PubMed Scopus (61) Google Scholar but what remains unclear is whether the operation actually prevents or reduces subsequent shortening. There is an obvious paucity of randomized trials comparing surgical with nonsurgical management in this situation. Second, a cervical length of ≤25 mm is commonly being quoted as the diagnostic criteria for a short cervix.2Iams JD Goldenberg RL Meis PJ et al.The length of the cervix and the risk of spontaneous prematurity.N Engl J Med. 1996; 334: 567-572Crossref PubMed Scopus (1512) Google Scholar I note that most of the “reproductive history” groups reached this cervical length at approximately the same gestational age in the current pregnancy as in their first preterm births, possibly implying an element of biologic timing. Response declined" @default.
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• W2065463911 title "Cervical length in high-risk pregnancies" @default.
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