Risk factors for cervical insufficiency after term delivery.
OBJECTIVE
Cervical insufficiency can be unexpected in a woman with a previous term birth. Our objective was to determine what risk factors, if any, place women with a term delivery at risk for cervical insufficiency in a subsequent pregnancy.


METHODS
Demographic characteristics were collected for a cohort of women with at least 1 previous term birth followed by cervical insufficiency (subject group) and for uncomplicated multiparous women (control group). Multiparous women with cervical insufficiency (subjects; n = 49) were compared with multiparous women who were experiencing repeat term birth with no history of cervical insufficiency (control group; n = 49).


RESULTS
Patients with cervical insufficiency were similar to control subjects demographically. No difference was noted in previous cervical procedures or spontaneous preterm deliveries. Multivariate logistic regression analysis identified a history of curettage (odds ratio, 4.6; 95% CI, 1.7-12.5), precipitous delivery (odds ratio, 6.8; 95% CI, 1.6-29.6), and prolonged second stage of labor (odds ratio, 24.9; 95% CI, 2.4-253) as independent predictors of cervical insufficiency.


CONCLUSIONS
Multiparous women who experience cervical insufficiency after a term birth are more likely to have had a previous precipitous delivery, a prolonged second stage of labor, or a previous curettage compared with multiparous women who experience a repeat term birth with no cervical insufficiency.
Vyas
Nisha A
NA
Department of Obstetrics and Gynecology, Georgetown University Hospital, Washington, DC 20007, USA. nvyas99@yahoo.com
Vink
Joy S
JS
Ghidini
Alessandro
A
Pezzullo
John C
JC
Korker
Victoria
V
Landy
Helain J
HJ
Poggi
Sarah H
SH
D000328:Adult; D016001:Confidence Intervals; D004107:Dilatation and Curettage; D005260:Female; D006801:Humans; D007748:Labor Stage, Second; D007744:Obstetric Labor Complications / Q000453:epidemiology; D016017:Odds Ratio; D011247:Pregnancy; D012307:Risk Factors; D002581:Uterine Cervical Incompetence / Q000453:epidemiology*