{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T01:14:47Z","timestamp":1780708487699,"version":"3.54.1"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T00:00:00Z","timestamp":1551225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32GM008562"],"award-info":[{"award-number":["T32GM008562"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Second trimester asymptomatic cervical dilation is a significant risk factor for early preterm birth. The objective of this study is to evaluate whether transvaginal ultrasound cervical length (<jats:styled-content style=\"fixed-case\">CL<\/jats:styled-content>) predicts asymptomatic cervical dilation on physical exam in women with short cervix (<jats:styled-content style=\"fixed-case\">CL<\/jats:styled-content> \u226425\u00a0mm) and no prior preterm birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Secondary analysis of a randomized trial on pessary in asymptomatic singletons without prior preterm birth diagnosed with <jats:styled-content style=\"fixed-case\">CL<\/jats:styled-content> \u226425\u00a0mm between 18<jats:sup>+0\/7<\/jats:sup> and 23<jats:sup>+6\/7<\/jats:sup>\u00a0weeks. Participants had transvaginal ultrasound and physical cervical exam and were randomized to pessary or no pessary with all patients with cervical length \u226420\u00a0mm offered vaginal progesterone. The primary outcome was to determine whether <jats:styled-content style=\"fixed-case\">CL<\/jats:styled-content> was predictive of asymptomatic physical cervical dilation \u22651\u00a0cm using receiver operating characteristic curve.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all, 119 women were included. Based on receiver operating characteristic curve, <jats:styled-content style=\"fixed-case\">CL<\/jats:styled-content> \u226411\u00a0mm was best predictive of cervical dilation \u22651\u00a0cm, with 75% sensitivity, 80% specificity, and area under the curve 0.73 (0.55\u20100.91), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.009. Cervical length \u226411\u00a0mm had increased incidence of cervical dilation \u22651\u00a0cm on physical exam (30% vs 3%, odds ratio 12.29 (3.05\u201049.37) <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) with a negative predictive value of 97%. Patients with \u22651\u00a0cm dilation had increased preterm birth &lt;37\u00a0weeks (75% vs 39%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.03) compared to those not dilated. Women with a <jats:styled-content style=\"fixed-case\">CL<\/jats:styled-content> \u226411\u00a0mm had increased preterm birth &lt;37\u00a0weeks (77% vs 31%, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001), preterm birth &lt;34\u00a0weeks (63% vs 22%, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001), and lower birthweight (1552\u00a0\u00b1\u00a01047 vs 2560\u00a0\u00b1\u00a01072\u00a0g, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) compared to women with <jats:styled-content style=\"fixed-case\">CL<\/jats:styled-content> &gt;11\u00a0mm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among singletons without prior preterm birth diagnosed with short cervix (\u226425\u00a0mm), <jats:styled-content style=\"fixed-case\">CL<\/jats:styled-content> \u226411\u00a0mm may identify a subgroup of patients at high risk for asymptomatic cervical dilation and poor perinatal outcome. Physical exam should be considered and adjunctive preterm birth prevention measures should be studied in singletons with <jats:styled-content style=\"fixed-case\">CL<\/jats:styled-content> \u226411\u00a0mm.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13545","type":"journal-article","created":{"date-parts":[[2019,1,25]],"date-time":"2019-01-25T13:55:47Z","timestamp":1548424547000},"page":"761-768","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Predicting asymptomatic cervical dilation in pregnant patients with short mid\u2010trimester cervical length: A secondary analysis of a randomized controlled trial"],"prefix":"10.1111","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3705-6943","authenticated-orcid":false,"given":"Rupsa C.","family":"Boelig","sequence":"first","affiliation":[{"name":"Division of Maternal Fetal Medicine Sidney Kimmel Medical College Thomas Jefferson University Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine","family":"Dugoff","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Roman","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine Sidney Kimmel Medical College Thomas Jefferson University Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7420-1807","authenticated-orcid":false,"given":"Vincenzo","family":"Berghella","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine Sidney Kimmel Medical College Thomas Jefferson University Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Ludmir","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine Sidney Kimmel Medical College Thomas Jefferson University Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,27]]},"reference":[{"issue":"1","key":"e_1_2_9_2_1","first-page":"1","article-title":"National Vital Statistics Reports Births: Final Data for 2015","volume":"64","author":"Martin JA","year":"2015","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.9017"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa067815"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17397"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182723b1b"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199602293340904"},{"issue":"17","key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"2840","DOI":"10.3109\/14767058.2015.1105957","article-title":"Cervical length, risk factors, and delivery outcomes among women with spontaneous preterm birth","volume":"29","author":"Boelig RC","year":"2016","journal-title":"J Matern Fetal Neonatal Med"},{"key":"e_1_2_9_9_1","unstructured":"BoeligRC VillaniM JiangE OrzechowskiK BerghellaV.Risk factors for early preterm birth in women with short cervix treated with vaginal progesterone. 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