In women with placenta accreta spectrum, a short cervical length (<25 mm) was not significantly associated with massive hemorrhage compared to a cervical length ≥25 mm.
Cohort (n=140)
No
Does a short cervical length (<25 mm) predict adverse maternal and neonatal outcomes in women with placenta accreta spectrum?
In women with placenta accreta spectrum, a short cervical length (<25 mm) is not an independent predictor of massive hemorrhage but is associated with more invasive placental phenotypes, longer antepartum hospitalization, and prolonged neonatal NICU stays.
Absolute Event Rate: 40.9% vs 38.5%
p-value: p=0.790
A short cervical length (CL) in placenta accreta spectrum (PAS) may be associated with adverse outcomes. This study aimed to evaluate the impact of CL on maternal and neonatal outcomes in PAS. This retrospective cohort study was conducted at hospitals affiliated with Shiraz University of Medical Sciences from January 2020 to December 2024. Transvaginal sonography was used to measure in women with PAS. Collected data included demographics, obstetric history, and maternal outcomes (e.g., bleeding volume, complications, ICU admission). Neonatal outcomes included gestational age, birth weight, Apgar scores, NICU admission, and mortality. Statistical analysis was performed using SPSS, employing chi-squared tests, logistic regression, and comparative analyses, with p 2000 mL, 40.9% vs. 38.5%, p = 0.790), emergency surgery (36.1% vs. 48.8%, p = 0.203), or intraoperative complications (25.6% vs. 29.2%, p = 0.664). Cervical length was not significantly associated with massive hemorrhage in univariate logistic regression analysis (OR 0.94, 95% CI 0.92–1.03, p = 0.378). Neonatal mortality and fetal demise were not significantly different(p = 0.672,0.372 respectively). However, neonates of mothers with CL < 25 mm had a longer median NICU stay (19 vs. 13 days, p = 0.012). In PAS, a short cervical length was not independently associated with massive hemorrhage but was linked to prolonged antepartum hospitalization and longer neonatal NICU stays. Adverse neonatal outcomes appear mediated by prematurity. CL assessment, combined with bleeding history, may aid in risk stratification and timing of delivery to improve outcomes.
Kasraeian et al. (2026) conducted a cohort in Placenta accreta spectrum (n=140). Cervical length <25 mm vs. Cervical length ≥25 mm was evaluated on Massive hemorrhage (>2000 mL) (p=0.790). In women with placenta accreta spectrum, a short cervical length (<25 mm) was not significantly associated with massive hemorrhage compared to a cervical length ≥25 mm.
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