6533b7cffe1ef96bd1258d8f

RESEARCH PRODUCT

P20Early membrane funnelling may occur from 16 weeks onwards and carries a worse prognosis

subject

description

Background Sonographic screening for cervical incompetence during pregnancy is currently a routine procedure. However, no consensus exists on the optimal gestational age to perform such screening. Method Serial transvaginal ultrasound examinations of the uterine cervix were routinely performed from 12 weeks onwards. The screening was considered positive when membrane funnelling was present or the cervical length was < 2 cm. Therapeutic measures included bed rest, antibiotics, tocolytic treatment and a modified McDonald's cervical suture (up to 25 weeks). Results Membrane funnelling was detected between 16 and 22 weeks (group A) in 9 women (31%); between 23 and 28 weeks (group B) in 11 women (38%) and between 29 and 36 weeks (group C) in 9 women (31%). Two women presented with hourglass membranes at 20 and 23 weeks, respectively. Comparison between groups A and B showed similar women characteristics and risk factors (P = NS). Delivery rate at ≤ 28 weeks was higher in group A (62.5%) than in group B (9.1%) (P < 0.03). Only one woman in group A and three in group B delivered at term. Conclusion This small series provides evidence to recommend serial monographic examinations of the uterine cervix, starting at 16 weeks. A greater risk of very premature delivery was evident when membrane funnelling was diagnosed before 23 weeks.