title: Uterine fibroids at routine second-trimester ultrasound survey and risk of sonographic short cervix.
abstract: OBJECTIVE
  To determine whether women with sonographically identified uterine fibroids are at higher risk for a short cervix.
  
  
  METHODS
  This retrospective cohort study evaluated all women with singleton gestations who had a routine second-trimester ultrasound at 17-23 weeks gestational age from 2010 to 2013. When fibroids were noted, their presence, number, location and size were recorded. Exclusion criteria included a history of cervical conization or loop electrosurgical excision procedure (LEEP), uterine anomalies, maternal age greater than 40 years, and a previously placed cerclage. The primary variable of interest was short cervix (<25 mm). Secondary variables of interest included gestational age at delivery, mode of delivery, indication for cesarean, malpresentation, birth weight, and Apgar scores. A multivariable logistic regression analysis was performed.
  
  
  RESULTS
  Fibroids were identified in 522/10 314 patients (5.1%). In the final multivariable logistic regression model, short cervix was increased in women with fibroids (OR 2.29, 95% CI: 1.40, 3.74). The number of fibroids did not affect the frequency of short cervix. Fibroids were significantly associated with preterm delivery (<37 weeks), primary cesarean, breech presentation, lower birth weight infants, and lower Apgar scores.
  
  
  CONCLUSIONS
  Women with uterine fibroids may be at higher risk for a short cervix. Fibroids are also associated with several adverse obstetric and neonatal outcomes.
authors.affiliation: a Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Hofstra North Shore-LIJ School of Medicine, North Shore University Hospital , Manhasset , NY , USA and.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Blitz
authors.affiliation: a Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Hofstra North Shore-LIJ School of Medicine, North Shore University Hospital , Manhasset , NY , USA and.
authors.forename: Burton
authors.initials: B
authors.lastname: Rochelson
authors.affiliation: a Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Hofstra North Shore-LIJ School of Medicine, North Shore University Hospital , Manhasset , NY , USA and.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Augustine
authors.affiliation: a Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Hofstra North Shore-LIJ School of Medicine, North Shore University Hospital , Manhasset , NY , USA and.
authors.forename: Meir
authors.initials: M
authors.lastname: Greenberg
authors.affiliation: b Biostatistics Unit, Feinstein Institute for Medical Research, Hofstra North Shore-LIJ School of Medicine, North Shore University Hospital , Manhasset , NY , USA.
authors.forename: Cristina P
authors.initials: CP
authors.lastname: Sison
authors.affiliation: a Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Hofstra North Shore-LIJ School of Medicine, North Shore University Hospital , Manhasset , NY , USA and.
authors.forename: Nidhi
authors.initials: N
authors.lastname: Vohra
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002584:Cervix Uteri / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000000981:diagnostic imaging*; D016015:Logistic Models; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000000981:diagnostic imaging*; D011262:Pregnancy Trimester, Second; D011295:Prenatal Care; D012189:Retrospective Studies; D012307:Risk Factors; D016216:Ultrasonography, Prenatal; D002581:Uterine Cervical Incompetence / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: Fibroids; preterm birth; short cervix; ultrasound