Role of Cervical Length in Predicting the Premature Labour: A Prospective Observational Study

Abstract

Background: Over the last decade, little progress has been made in understanding and preventing preterm birth, and the incidence of spontaneous preterm birth has continued to rise, even in low risk women. One of the key predictors of premature birth is cervical length. Methods: This was a hospital based prospective study conducted at the postgraduate department of obstetrics and gynecology, Government Lalla Ded Hospital, Srinagar for a period of one and a half year (2019-2021). Out of the 140 women, 36 were removed from the research owing to rescue or emergency cerclage, and 22 women were lost to follow-up. For the 82 remaining women, the association between cervical length between the 16th and 24th week of pregnancy and premature birth was examined. Results: We observed that 2.5 cm cervical length was the ideal cut-off with sensitivity, specificity, positive predictive, negative predictive, and accuracy values of (68.7%), (75.7%), (77.5%), (66.7%), and (71.9%), respectively. The average cervical length of patients with gestational age at delivery fewer than 37 weeks was significantly smaller compared to those with gestational age more than 37 weeks at delivery (2.75 vs 3.92, p-value < 0.001). Conclusion: We concluded that a short cervical length of <2.5cm is a risk factor for development of spontaneous preterm labour and that ≤ 2.5mm is an optimum threshold for it. Our findings imply that the cervix's length is a reliable predictor of its competence and should be seen as a continuous rather than a binary characteristic. Preterm birth is more likely to occur if the cervix is shorter than normal. The length of the cervix strongly correlates with the length of pregnancy. Keywords: Cervical length, Preterm, Pregnancy