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 journalArticlepeer-review

34 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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