1164: Cervical length in women with congenital uterine anomalies

We sought to measure the incidence of short transvaginal cervical length (TVCL) in women with congenital uterine anomalies (CUA), and to determine whether this incidence varies by primary CUA type. This is a retrospective cohort study of women with known CUAs who delivered at two tertiary health systems from 2013 to 2019. We included women carrying non-anomalous, singleton gestations who had ≥1 TVCL measurement between 16-24 weeks’ gestation. CUAs were classified as arcuate, septate, unicornuate, bicornuate, or didelphys. The primary outcome was measurement of a short TVCL < 25mm prior to 24 weeks’ gestation. Secondary outcomes include the shortest TVCL (in mm) per CUA type. Data were stratified by type of uterine anomaly and history of prior preterm birth (PTB), and were analyzed by Wilcoxon rank sum, Fisher’s exact and chi squared tests. 120 women met inclusion criteria. The most common CUA was bicornuate (36.7%) followed by septate (30.0%), unicornuate (13.3%), arcuate (10.0%), and didelphys (10.0%). Demographic and obstetric characteristics are shown in Table 1. Overall, 13 (10.8%) women developed a short cervix < 25 mm. A similar proportion of women with each CUA type developed a short cervix (Table 2). The median shortest TVCL was similar among CUA types. Prior PTB was common in this cohort, ranging from 18.8-41.7% by CUA type (Table 2). Among women with prior PTB, the incidence of a short TVCL and the median shortest TVCL did not vary by CUA type (p >0.99, p=0.62). Though rates of prior PTB were high in this cohort of women with CUA, the overall incidence of short TVCL approximated that of the general obstetric population and did not vary by CUA type or prematurity history.View Large Image Figure ViewerDownload Hi-res image Download (PPT)