Mid-Pregnancy Ultrasonographic Cervical Length Measurement (A Predictor of Mode and Timing of Delivery): An Observational Study.

Objective

Even though cervical length is considered as predictor of timing and mode of delivery, it is not used as a screening tool in low risk asymptomatic population. This study was carried out with the intention to know the timing and mode of delivery in asymptomatic low risk women using second trimester ultrasonographic cervical length measurement and predict the risk of pretermlabor, prolonged pregnancy and need for caesarean section. 1) To determine the association between cervical length at mid-pregnancy and timing of delivery. 2) To determine the usefulness of mid-pregnancy ultrasonographic cervical length measurement in predicting mode of delivery. Materials and methods: Transvaginal sonography was performed to measure the cervical length between 20-24 weeks of gestation. These patients were followed till delivery to assess the gestational age at delivery and mode of delivery.

Results

Totally 237 patients were recruited of which 173 satisfied the inclusion criteria. Out of 15 patients with cervical length less than 3cm, 14(93.33%) had preterm delivery. Postdated pregnancy was observed in 45(90%) out of 50 patients with cervical length more than 4cm. In the group with cervical length less than 3cm, 12 (80%) delivered vaginally. Among cervical length more than 4cm group 24 (48%) required cesarean section.

Conclusion

Cervical length of less than 3cm measured between 20-24 weeks of gestation is associated with preterm births and favours vaginal birth whereas, cervical length of more than 4cm is associated with postdated pregnancy and increased incidence of cesarean section.