P32.06: Role of cervical length at 22–26 weeks as a predictor of Caesarean delivery in primiparous women at term: transvaginal ultrasound assessment

Abstract

To evaluate the accuracy of transvaginal ultrasound (TVUS) assessment of cervical length at 22–26 weeks in predicting the probability of Caesarean delivery in primiparous women at term. 120 primiparous between 22–26 weeks of a healthy pregnancy were enrolled in this prospective study (2005–2008). Cervical length by TVUS was assessed at 22–26 weeks of gestation. TVUS showing cervical length shorter than 15 mm, those who delivered before term as well as women with pre-existing significant medical history were excluded from the study. The patient term delivery data were analyzed including the gestational age at delivery, mode of delivery, the reason for Caesarean section and neonatal outcomes. Only 91 patients delivered at term and their complete data were included into this analysis. Patient's data were collected according to quartile of cervical length measured at 22–26 weeks. There were no obvious changes between the patients in the 4th quartiles (age, BMI, gestational age of delivery, neonatal weight). The Caesarean section rate was higher in patients in the 4th quartile (40–50 mm) than patients in the 1st quartile of cervical length (20%). Accuracy of TVUS assessment of cervical length in the evaluation failure of progress in labour as a cause for Caesarean section was significantly (P < 0.05) higher in patients in the 4th quartile. Our results show that assessment of the cervical length at 22–26 weeks by TVUS should be used to predict Caesarean delivery at term in primiparous women.