Cervical Length at Term Pregnancy as a Predictor of Spontaneous Delivery Within a Week: A Sonographic Study

Abstract

Objective:

To evaluate cervical length (CL), at term pregnancy, as a predictor of spontaneous delivery, within a week.

Materials and Methods:

This was a cross-sectional study conducted, within the radiology and gynecology department, at a hospital, in the Republic of Pakistan. The study’s inclusion criteria were to invite pregnant patients without complications, at the estimated gestational age (GA) > 37 weeks, and ages 18–45 years. Patients with no history of previous caesarian section, no evidence of intrauterine growth restriction (IUGR), or other fetal anomalies were included. The exclusion criteria were based on patients admitted for threatened preterm labor, earlier in pregnancy. Additionally, fetal anomalies, mortality, and maternal complications were also excluded. It was also important to exclude patients with a prior uterine surgery and/or uterine abnormalities. All patients were evaluated with a transabdominal sonogram to document the cervix and make the measurement of CL.

Results:

There were 329 patients consented to the study. Eight of the 329 individuals had to have a cesarean section; therefore, they were excluded. The mean age of patients was 25.48 ± 4.8 years. The mean GA was 36.91 ± 0.6 weeks. The mean CL was 32.1 ± 7 mm. Furthermore, the categorization of CL (<30 and >30mm) showed that 42.4% of cases had a CL < 30mm, while 57.6% had a CL > 30mm. When the CL was < 30mm, there were no delivery complications, within 7 days, among 136 patient cases. However, for CL > 30mm, not all 185 patients delivered within a week. In this cohort, the CL diagnostic cutoff, for spontaneous birth within a week, was 30mm, when CL was measured within 7 days.

Conclusion:

In this cohort, the one factor that predicted the spontaneous start of labor and delivery, within a week, was a CL < 30mm, between 37 and 38 weeks of gestation. In this group of patients, CL> 30mm, the rate of late-term delivery was somewhat greater, by comparison.