Publication:

Predicting mode of delivery using mid‑pregnancy ultrasonographic measurement of cervical length among nulliparous women

Background Numerous studies have demonstrated that measuring the cervical length using transvaginal ultrasonography in singleton pregnancies at 20-24 weeks gestation can be a valuable technique for predicting the likelihood of a severe preterm birth. The association between cervical length at 20-24 weeks and the likelihood of a term cesarean section birth has, however, not been well researched. The purpose of this research is to ascertain if mid-pregnancy ultrasonography cervical length measurements are effective in anticipating term cesarean sections. Our hypothesis in this study is that there is no correlation between mid-pregnancy cervical length and the chance of a cesarean section during term labor.

Methods One hundred pregnant women, ranging in gestation from twenty to twenty-four weeks, were enrolled in the study. Individuals were chosen from the prenatal outpatient clinic. The gestational age varied from 36 to 40 (38.7±2.2 weeks). Of the cases, 53 women (53%) had a normal birth, and 47 women (47%) had a cesarean section. Four sets of data were identified based on the cervical length quartile: first quartile (15-24 mm), second quartile (25-29 mm), third quartile (30-39 mm), and fourth quartile (40-50 mm).

Results Patients with cervical lengths in the second quartile (18.2%) had the lowest rate of cesarean sections (18.6%), whereas patients with cervical lengths in the fourth quartile (96.6%) had considerably higher rates (p<0.00). Patients in the fourth quartile had a substantially higher (p<0.00) frequency of cesarean sections due to labor failure (6.38%). Logistic regression analysis revealed that the odds ratio (OR) for cesarean section in labor was lowest among patients in the first quartile (OR=1.94) and highest among patients in the fourth quartile (OR=2.95). The cervical length quartile did not significantly differ in terms of neonatal outcomes, with exception of birth weight, which did significantly differ.

Conclusions For patients who are nulliparous, the cervical length measured by transvaginal ultrasonography at mid-gestation can be used to predict the chance of a cesarean delivery at term.