{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:07:00Z","timestamp":1790053620296,"version":"4.0.1"},"reference-count":18,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Ultrasound"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Placenta accreta spectrum (PAS) has high maternal morbidity and poor neonatal outcomes, although the best time for delivery is not clear. Cervical length (CL) may serve as a useful adjunct for risk stratification and individualized delivery planning in PAS pregnancies.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To examine the association of serial cervical length measurement with delivery timing and maternal and neonatal outcomes in women with PAS.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In this prospective cohort study at three university hospitals in Tehran, 41 pregnant women antenatally diagnosed with PAS had transvaginal sonographic CL measurements performed at 28, 32, and 34\u2009weeks' gestation. The main outcome was gestational age at delivery and its connection with the CL. Maternal complications and neonatal morbidity constituted secondary outcomes.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Short CL (<\u200925\u2009mm) at 28 and 32\u2009weeks was significantly related to delivery at \u2264\u200934\u2009weeks (\n p<\/jats:italic>\n \u2009<\u20090.05) and increased Cesarean hysterectomy rates (\n p<\/jats:italic>\n \u2009=\u20090.002 at 32\u2009weeks;\n p<\/jats:italic>\n \u2009=\u20090.005 at 34\u2009weeks). Emergent Cesarean delivery was more common among PAS patients with CL <\u200925\u2009mm at 32 and 34\u2009weeks (\n p<\/jats:italic>\n \u2009=\u20090.02). Neonates from mothers with short CL had increased likelihood for antibiotics, surfactant, resuscitation, and intubation (all\n p<\/jats:italic>\n \u2009<\u20090.05). No significant relations were seen for CL and intraoperative bladder damage or estimated blood loss.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Cervical shortening in the late second and early third trimester in PAS women is significantly associated with earlier term delivery, increased risk of Cesarean hysterectomy, and neonatal morbidity for PAS pregnancies. Repeated assessments of CL may be a useful adjunct for individualizing delivery timing and optimizing maternal\u2010fetal outcomes. Larger prospective multicenter trials are essential to validate the role of CL in risk stratification and to integrate it into an individualized delivery planning algorithm.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jcu.70387","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:49:06Z","timestamp":1790052546000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating Cervical Length in Placenta Accreta Spectrum and Its Effects on Maternal and Fetal Outcomes: A Prospective Cohort Study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3779-9218","authenticated-orcid":false,"given":"Sedigheh","family":"Hantoushzadeh","sequence":"first","affiliation":[{"name":"Vali\u2010E\u2010Asr Reproductive Health Research Center, Family Health Research Institute, Emam Complex Hospital Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sedigheh","family":"Borna","sequence":"additional","affiliation":[{"name":"Vali\u2010E\u2010Asr Reproductive Health Research Center, Family Health Research Institute, Emam Complex Hospital Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahimeh Ghotbizadeh","family":"Vahdani","sequence":"additional","affiliation":[{"name":"Vali\u2010E\u2010Asr Reproductive Health Research Center, Family Health Research Institute, Emam Complex Hospital Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Panahi","sequence":"additional","affiliation":[{"name":"Vali\u2010E\u2010Asr Reproductive Health Research Center, Family Health Research Institute, Emam Complex Hospital Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3355-9121","authenticated-orcid":false,"given":"Hediye","family":"Gholamshahi","sequence":"additional","affiliation":[{"name":"Vali\u2010E\u2010Asr Reproductive Health Research Center, Family Health Research Institute, Emam Complex Hospital Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0133-4788","authenticated-orcid":false,"given":"Leila","family":"Sahebi","sequence":"additional","affiliation":[{"name":"Maternal, Fetal, and Neonatal Research Center, Family Health Research Institute Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masoumeh","family":"Masoumi","sequence":"additional","affiliation":[{"name":"Vali\u2010E\u2010Asr Reproductive Health Research Center, Family Health Research Institute, Emam Complex Hospital Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3663-5763","authenticated-orcid":false,"given":"Sooreh","family":"Sheykham","sequence":"additional","affiliation":[{"name":"Vali\u2010E\u2010Asr Reproductive Health Research Center, Family Health Research Institute, Emam Complex Hospital Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2306-7112","authenticated-orcid":false,"given":"Marjan","family":"Ghaemi","sequence":"additional","affiliation":[{"name":"Vali\u2010E\u2010Asr Reproductive Health Research Center, Family Health Research Institute, Emam Complex Hospital Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"issue":"6","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1097\/AOG.0000000000005903","article-title":"Biology and Pathophysiology of Placenta Accreta Spectrum Disorder","volume":"145","author":"Afshar Y.","year":"2025","journal-title":"Obstetrics and Gynecology"},{"issue":"10","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"101451","DOI":"10.1016\/j.ajogmf.2024.101451","article-title":"Quantifying Placenta Accreta Spectrum Severity and Its Associated Blood Loss: A Novel Transvaginal Ultrasound Scoring System","volume":"6","author":"Agarwal N.","year":"2024","journal-title":"American Journal of Obstetrics & Gynecology MFM"},{"issue":"1","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1186\/s12884-025-07952-y","article-title":"Algorithm for Timing of Delivery in Placenta Accreta Spectrum: Role of Cervical Length and Number of Antepartum Bleeding","volume":"25","author":"Bucak M.","year":"2025","journal-title":"BMC Pregnancy and Childbirth"},{"issue":"6","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"B2","DOI":"10.1016\/j.ajog.2018.09.042","article-title":"Placenta Accreta Spectrum","volume":"219","author":"Cahill A. G.","year":"2018","journal-title":"American Jjournal of Oobstetrics and Ggynecology"},{"issue":"11","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"e722","DOI":"10.1542\/neo.22-11-e722","article-title":"Placenta Accreta Spectrum","volume":"22","author":"Donovan B. M.","year":"2021","journal-title":"NeoReviews"},{"issue":"2","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1002\/uog.27465","article-title":"Determinants of Emergency Cesarean Delivery in Pregnancies Complicated by Placenta Previa With or Without Placenta Accreta Spectrum Disorder: Analysis of ADoPAD Cohort","volume":"63","author":"Group AADoPADS","year":"2024","journal-title":"Ultrasound in Obstetrics & Gynecology"},{"issue":"5","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"101172","DOI":"10.1016\/j.ajogmf.2023.101172","article-title":"Ultrasonographic Cervical Length Assessment in Pregnancies With Placenta Previa and Risk of Perinatal Adverse Outcomes: A Systematic Review and Meta\u2010Analysis","volume":"6","author":"Hessami K.","year":"2024","journal-title":"American Journal of Obstetrics & Gynecology MFM"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","DOI":"10.3389\/fsurg.2022.1028494","article-title":"Association Between Cervical Length and Massive Intraoperative Bleeding in Patients With Suspected Placenta Accreta Spectrum Combined With Placenta Previa: A Retrospective Cohort Study","volume":"9","author":"Huang F.","year":"2022","journal-title":"Frontiers in Surgery"},{"issue":"1","key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1038\/s41572-025-00624-3","article-title":"Placenta Accreta Spectrum","volume":"11","author":"Jauniaux E.","year":"2025","journal-title":"Nature Reviews. Disease Primers"},{"issue":"2","key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.ajog.2023.02.021","article-title":"Perinatal Assessment of Complex Cesarean Delivery: Beyond Placenta Accreta Spectrum","volume":"229","author":"Jauniaux E.","year":"2023","journal-title":"American Journal of Obstetrics and Gynecology"},{"key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1002\/jum.16729","article-title":"Cervical Length in Patients With Placenta Accreta Spectrum and Its Association With Unscheduled Delivery","volume":"44","author":"Kassir E.","year":"2025","journal-title":"Journal of Ultrasound in Medicine"},{"key":"e_1_2_10_13_1","first-page":"CD004454","article-title":"Antenatal Corticosteroids for Accelerating Fetal Lung Maturation for Women at Risk of Preterm Birth","volume":"12","author":"McGoldrick E.","year":"2020","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_10_14_1","doi-asserted-by":"crossref","first-page":"174550651987808","DOI":"10.1177\/1745506519878081","article-title":"Placenta Accreta Spectrum: Risk Factors, Diagnosis and Management With Special Reference to the Triple P Procedure","volume":"15","author":"Pi\u00f1as Carrillo A.","year":"2019","journal-title":"Women's Health (London, England)"},{"issue":"7","key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.7863\/ultra.16.05059","article-title":"Cervical Length in Patients at Risk for Placenta Accreta","volume":"36","author":"Rac M. W. F.","year":"2017","journal-title":"Journal of Ultrasound in Medicine"},{"issue":"10","key":"e_1_2_10_16_1","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.7863\/ultra.32.10.1721","article-title":"Comparison of Cervical Lengths Using Transabdominal and Transvaginal Sonography in Midpregnancy","volume":"32","author":"Roh H.\u2010J.","year":"2013","journal-title":"Journal of Ultrasound in Medicine"},{"issue":"2","key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"e0149036","DOI":"10.1371\/journal.pone.0149036","article-title":"Serial Change in Cervical Length for the Prediction of Emergency Cesarean Section in Placenta Previa","volume":"11","author":"Shin J. E.","year":"2016","journal-title":"PLoS One"},{"key":"e_1_2_10_18_1","volume-title":"Society for Maternal\u2010Fetal Medicine Special Statement: Quality Metrics for Optimal Timing of Antenatal Corticosteroid Administration","author":"Society for Maternal\u2010Fetal Medicine (SMFM)","year":"2025"},{"issue":"1","key":"e_1_2_10_19_1","doi-asserted-by":"crossref","first-page":"38.e1","DOI":"10.1016\/j.ajog.2011.01.040","article-title":"Predictors of Massive Blood Loss in Women With Placenta Accreta","volume":"205","author":"Wright J. D.","year":"2011","journal-title":"American Journal of Obstetrics and Gynecology"}],"container-title":["Journal of Clinical Ultrasound"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcu.70387","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jcu.70387","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcu.70387","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:49:26Z","timestamp":1790052566000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcu.70387"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":18,"alternative-id":["10.1002\/jcu.70387"],"URL":"https:\/\/doi.org\/10.1002\/jcu.70387","archive":["Portico"],"relation":{},"ISSN":["0091-2751","1097-0096"],"issn-type":[{"value":"0091-2751","type":"print"},{"value":"1097-0096","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]},"assertion":[{"value":"2025-09-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jcu.70387"}}