Abstract
Objectives: To assess the role of mid-trimester transvaginal sonographic assessment of cervix in predicting the risk of primary cesarean section. Methods: Hundred pregnant women, who attended out-patient department of Tata Main Hospital for ante natal examination, from 1st December 2011 to 1st December 2012, were taken up for the study. Only those who had confirmed dates were included in the study. Transvaginal sonography was done at 18 - 26 week to measure cervical length. Parameters studied were gestational age at delivery, whether spontaneous or induced, duration of labor, pregnancy outcome and mode of delivery and indication for cesarean section. Results: Majority of LSCS were in the group with cervical length ≥4 cm (57.1%) with “p” value of predictive value of cervical length as a predictor of mode of delivery was 54.8%, 91.4%, 82.1% and 73.6% respectively. R2 (coefficient of determination) was 0.271. Conclusion: Transvaginal cervical length measurement at mid trimester can be used as a predictive tool to determine the risk of primary cesarean section as well as the need of induction of labor.
Highlights
The cervical length is known to influence outcome of labor
The major cause of primary cesarean section is poor progression of labor..In recent years, a few workers have shown that cervical length at mid-pregnancy is an independent predictor of risk of cesarean section in primiparous women
C A Kalu et al [4] studied the role of mid pregnancy transvaginal cervical length measurement in prediction of pregnancy outcome and concluded that long mid trimester transvaginal cervical length could predict risk of cesarean section
Summary
The cervical length is known to influence outcome of labor. The major cause of primary cesarean section is poor progression of labor (dystocia)..In recent years, a few workers have shown that cervical length at mid-pregnancy is an independent predictor of risk of cesarean section in primiparous women. Increased cervical length has been found to be associated with risk of increased induction to delivery interval and poor progress of labor [1]-[4]. Various methods of cervical length measurement have been used which includes digital, transabdominal, transvaginal and transperineal. Transvaginal sonographic method of cervical length measurement is generally the most preferred method. The results of studies that have evaluated the accuracy of transvaginal ultrasound for the prediction of the outcome of induction remain controversial. Some investigators have reported that transvaginal ultrasonographic assessments of the cervix are of value for predicting the outcome of induction [5] [6], whereas others have argued against it [7] [8]
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