Cervical funneling: Effect on gestational length and ultrasound-indicated cerclage in high-risk women

Melissa S. Mancuso, Jeff M. Szychowski, John Owen, Gary Hankins, Jay D. Iams, Jeanne S. Sheffield, Annette Perez-Delboy, Vincenzo Berghella, Debora A. Wing, Edwin R. Guzman

Research output: Contribution to journalArticle

27 Scopus citations

Abstract

Objective The purpose of this study was to assess funnel type and pregnancy duration in women with previous spontaneous preterm birth and cervical length <25 mm. Study Design We performed a secondary analysis of a multicenter randomized trial of cerclage. At the randomization scan that documented short cervix, the presence and type of funnel (U or V) were recorded. Results One hundred forty-seven of 301 women (49%) had funneling: V-shaped funnel, 99 women; U-shaped funnel, 48 women. U-shaped funnel was associated significantly with preterm birth at <24, <28, <35, and <37 weeks of gestation. In multivariable models that controlled for randomization cervical length and cerclage, women with U-shaped funnel delivered earlier than women with either V-shaped funnel or no funnel. Interaction between cerclage and U-shaped funnel was observed, and analyses that were stratified by cerclage showed that women with a U-shaped funnel and cerclage delivered at a mean of 33.8 ± 6.6 weeks of gestation, compared with women who did not receive cerclage (28.9 ± 6.9 weeks of gestation). Conclusion U-shaped funnels in high-risk women with a short cervix are associated with earlier birth.

Original languageEnglish (US)
Pages (from-to)259.e1-259.e5
JournalAmerican journal of obstetrics and gynecology
Volume203
Issue number3
DOIs
StatePublished - Sep 2010

Keywords

  • U-shaped funnel
  • V-shaped funnel
  • preterm birth

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Mancuso, M. S., Szychowski, J. M., Owen, J., Hankins, G., Iams, J. D., Sheffield, J. S., Perez-Delboy, A., Berghella, V., Wing, D. A., & Guzman, E. R. (2010). Cervical funneling: Effect on gestational length and ultrasound-indicated cerclage in high-risk women. American journal of obstetrics and gynecology, 203(3), 259.e1-259.e5. https://doi.org/10.1016/j.ajog.2010.07.002