OP19.06: Cervical length and risk of antepartum bleeding in women with complete placenta praevia

Abstract

To evaluate if cervical length may predict antepartum bleeding and emergency Cesarean section in cases of low-lying placenta. Between September 2004 and July 2006, cervical length was measured by transvaginal ultrasound in women with complete placenta praevia persisting in the third trimester of pregnancy. A complete follow-up of pregnancy was obtained in all cases. Overall 37 women were included in the study group. The median gestational age at ultrasound was 31 (range, 26–36) weeks with a mean cervical length of 36.3 ± 9.35 mm. Cesarean delivery was performed in all cases at a median age of 35 (range, 28–38) weeks. Of the entire group, 19 women (51.3%) presented with antepartum bleeding and nine (24.3%) required an emergency Cesarean section prior to 34 completed weeks due to massive haemorrage. Cervical length did not differ significantly among cases with or without antepartal bleeding (34.5 ± 9.25 mm vs. 38.2 ± 9.34 mm; P = 0.23), but was significantly shorter among patients who underwent emergency Cesarean section (30.0 ± 5.84 mm vs. 38.1 ± 9.67; P < 0.05). Transvaginal ultrasound assessment of cervical length may predict the risk of emergency Cesarean section at ≤34 weeks in women with complete placenta praevia.