TITLE:
Midtrimester pregnancy loss and cervical incompetence—Is there an association with connective tissue laxity?
AUTHORS:
Shirley Au, Fiona Cullinane, Ravi Savarirayan, Sonia R. Grover
KEYWORDS:
Cervical Incompetence; Connective Tissue Laxity; Ehlers Danlos Syndrome; Pregnancy Complications; Beighton Score
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.4 No.1,
January
6,
2014
ABSTRACT: Objectives: The basic
mechanisms of cervical incompetence remain unknown although preliminary histological,
biochemical and DNA studies suggest connective tissue pathology may be a
contributing factor. Certain connective
tissue disorders are known to be associated with obstetric complications.
Utilising a standardised established scoring
system for connective tissue laxity, this study aimed to test the
relationship between clinical evidence of connective tissue laxity and cervical incompetence. Methods: This case-control
study involved pregnant and non-pregnant women with a history of
mid-trimester pregnancy loss in the absence of major bleeding, infection and
uterine abnormalities and a control group of women with uncomplicated obstetric
histories. Relevant medical details were obtained. Connective tissue laxity was
assessed utilizing the Beighton scoring system. Potential confounding factors,
including age, pregnancy and gestation were explored. Results: The frequency of
connective tissue laxity between the cases [n = 29] was not statistically
different from the controls [n = 58] [p = 0.391] suggesting a lack of
association between cervical incompetence and clinical evidence of connective
tissue laxity. Conclusion: Although no clear evidence of connective tissue laxity
was demonstrated, it is possible that cervical incompetence is associated with
abnormal connective tissue. But this abnormality is different from the defect
that underlies joint hypermobility and skin elasticity.