The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2026
Can transvaginal and transabdominal cervical length measurements at 37 weeks predict the risk of prolonged pregnancy?
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Bezirganoglu Altuntas Neslihan, Baki Yıldırım Sema
Аннотация
OBJECTIVE: To evaluate the role of transvaginal and transabdominal cervical length (CL) measurements at 37 weeks of gestation in predicting the risk of prolonged pregnancy among nulliparous women.
METHODS: A retrospective cohort study was conducted between February 2022 and June 2024 at a regional tertiary maternity hospital. Transvaginal (TVS) and transabdominal sonography (TAS) were performed in low-risk nulliparous patients at 37 weeks of gestation. Patients were categorized into two groups based on delivery time: <41 weeks (term) and ≥41 weeks (late-term). Demographic, obstetric, and ultrasonographic parameters were compared between groups. Logistic regression was used to identify independent predictors of late-term delivery. Agreement between TVS and TAS measurements was assessed using Bland-Altman analysis. Statistical analyses were performed using SPSS software (version 27.0; IBM SPSS Inc., Chicago, IL, USA) and a p value < 0.05 was considered statistically significant.
RESULTS: A total of 179 patients were included in the study. Of these, 19 (10.6%) were classified as late-term group, while 160 (89.4%) were classified as term group. Maternal age and BMI were similar between groups. The median CL was higher in the late-term group by both TVS and TAS; however, only TVS-CL remained statistically significant (p = 0.032) in the late-term group. Bland-Altman analysis showed acceptable agreement between TAS and TVS measurements with a mean difference of 1.47 mm and 95% limits of agreement ranging from -6.8 to 9.8 mm. After adjusting for potential confounders, a longer TVS-CL was independently associated with an increased risk of late-term delivery (adjusted OR = 1.26; 95% CI 1.01-1.58). A positive correlation was observed between measured transvaginal CL at 37 weeks and gestational age at delivery.
CONCLUSION: A longer cervical length measured by transvaginal sonography at 37 weeks was independently associated with an increased risk of late-term delivery. Our findings demonstrate the potential value of standardized ultrasonographic assessment in identifying women at risk of prolonged pregnancy, which could help optimize perinatal outcomes.
METHODS: A retrospective cohort study was conducted between February 2022 and June 2024 at a regional tertiary maternity hospital. Transvaginal (TVS) and transabdominal sonography (TAS) were performed in low-risk nulliparous patients at 37 weeks of gestation. Patients were categorized into two groups based on delivery time: <41 weeks (term) and ≥41 weeks (late-term). Demographic, obstetric, and ultrasonographic parameters were compared between groups. Logistic regression was used to identify independent predictors of late-term delivery. Agreement between TVS and TAS measurements was assessed using Bland-Altman analysis. Statistical analyses were performed using SPSS software (version 27.0; IBM SPSS Inc., Chicago, IL, USA) and a p value < 0.05 was considered statistically significant.
RESULTS: A total of 179 patients were included in the study. Of these, 19 (10.6%) were classified as late-term group, while 160 (89.4%) were classified as term group. Maternal age and BMI were similar between groups. The median CL was higher in the late-term group by both TVS and TAS; however, only TVS-CL remained statistically significant (p = 0.032) in the late-term group. Bland-Altman analysis showed acceptable agreement between TAS and TVS measurements with a mean difference of 1.47 mm and 95% limits of agreement ranging from -6.8 to 9.8 mm. After adjusting for potential confounders, a longer TVS-CL was independently associated with an increased risk of late-term delivery (adjusted OR = 1.26; 95% CI 1.01-1.58). A positive correlation was observed between measured transvaginal CL at 37 weeks and gestational age at delivery.
CONCLUSION: A longer cervical length measured by transvaginal sonography at 37 weeks was independently associated with an increased risk of late-term delivery. Our findings demonstrate the potential value of standardized ultrasonographic assessment in identifying women at risk of prolonged pregnancy, which could help optimize perinatal outcomes.