title: Risk factors for cervical insufficiency after term delivery.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Georgetown University Hospital, Washington, DC 20007, USA. nvyas99@yahoo.com
authors.forename: Nisha A
authors.initials: NA
authors.lastname: Vyas
authors.forename: Joy S
authors.initials: JS
authors.lastname: Vink
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ghidini
authors.forename: John C
authors.initials: JC
authors.lastname: Pezzullo
authors.forename: Victoria
authors.initials: V
authors.lastname: Korker
authors.forename: Helain J
authors.initials: HJ
authors.lastname: Landy
authors.forename: Sarah H
authors.initials: SH
authors.lastname: Poggi
mesh_terms: 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*