Assessment of transvaginal ultrasound measurement of cervical length for prediction of spontaneous onset of labor at term

Shweta Walke,Alka Patankar,Bhakti Deshpande

doi:10.18231/j.ijogr.2020.088

Shweta Walke, Alka Patankar + Show 1 more

Open Access

https://doi.org/10.18231/j.ijogr.2020.088

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Abstract

The objective of this study was to measure the cervical length by transvaginal sonography at term to predict onset and course of spontaneous labor. One hundred and nighty nine pregnant women between 37 to 40 weeks of gestation who fulfilled the inclusion criteria were enrolled in this prospective observational study conducted in department of obstetrics and gynecology of IGGMC, NAGPUR. Out of 199 pregnant women, 154 women had full term vaginal delivery and 45 women underwent emergency cesarean section. The mean cervical length was 2.58cm in women who had vaginal birth and was 3.45cm in women who underwent emergency cesarean section. The best cutoff of transvaginal cervical length was 2.7cm for predicting the spontaneous onset of labor within 7 days, having sensitivity of 90.91% and specificity of 84%.The positive predictive value was 84.9% and negative predictive value of test 90.3%, with diagnostic accuracy of 87.4%. When cervical length is less, then chances of vaginal delivery are significantly higher. Transvaginal cervical length measurement between 37 to 40 weeks is useful test for predicting spontaneous onset of labor within 7 days. It helps women and healthcare providers to plan vaginal birth and also timely decision of referral of those cases requiring immediate care to higher centres for better maternal and foetal outcome.

Highlights

One of the most common question a pregnant women asks is “when will I deliver?” and this question becomes even more frequent one to be asked as expected due date gets closer
Study of effect of parity on the predictive value of cervical length for spontaneous onset of labour was outside the purview of our study, we found similar study by Vankayalapati2 conducted previously which shows direct effect of parity on cervical length at term
The data was analyzed according to parity, where they found that, the ability of cervical length measurement to predict spontaneous onset of labor disappears for parous women

Summary

Introduction

One of the most common question a pregnant women asks is “when will I deliver?” and this question becomes even more frequent one to be asked as expected due date gets closer. A decrease in collagen concentration and an increase elastin/collagen ratio softens the rigid structure of the cervix. This transformation is called “Cervical Ripening’ and enables the cervix to dilate and facilitate parturition. 1 The objective of this study was to measure the cervical length by Transvaginal sonography at term to obtain more insight in physiological changes preceding parturition and to relate these changes to predict onset and course of spontaneous labour. The objective of this study was to measure the cervical length by transvaginal sonography at term to predict onset and course of spontaneous labor. Transvaginal cervical length measurement between 37 to 40 weeks is useful test for predicting spontaneous onset of labor within 7 days. It helps women and healthcare providers to plan vaginal birth and timely decision of referral of those cases requiring immediate care to higher centres for better maternal and foetal outcome

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