Can sonographic measurements and changes in cervical length during pregnancy predict preterm labour in an asymptomatic low-risk population?

J Matern Fetal Neonatal Med. 2019 Jul;32(13):2107-2112. doi: 10.1080/14767058.2018.1425990. Epub 2018 Jan 18.

Abstract

Objective: This study measured cervical length (CL) at 14-16 and 21-24 weeks of gestation and assessed whether the difference between the measurements is predictive of preterm delivery (PTD).

Methods: This retrospective, cohort study included patients with two consecutive CL measured with transvaginal sonography at 14-16 weeks of gestation (CL1) and 21-24 weeks (CL2). Electronic medical records were reviewed for demographic, medical and obstetric history; complications during the current pregnancy and delivery data. CL1, CL2 and the change between scans were evaluated and correlated to PTD prediction.

Results: Among the 216 patients, 196 (90.7%) delivered at term (≥37 weeks) and 20 (9.3%) preterm (<37 weeks). CL1 was not a good predictor of PTD (p = .70). CL2 was significantly shorter in the PTD group (p < .05). The correlation between CL change and PTD was not significant (p = .55). Perinatal outcomes between term and preterm deliveries were similar.

Conclusions: Sonographic measurement of CL at 14- to 16-week gestation and the difference between CL in the first and second scans are not reliable predictors of PTD. However, cervical length at 21-24 weeks in low-risk women is predictive of this complication.

Keywords: Cervical length measurement; cervical length change; low-risk pregnant women; preterm labour.

MeSH terms

  • Case-Control Studies
  • Cervical Length Measurement*
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Obstetric Labor, Premature / diagnosis
  • Obstetric Labor, Premature / epidemiology*
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Trimester, Second
  • Retrospective Studies
  • Risk Factors