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Cervical length at 16-22 weeks' gestation and risk for preterm delivery.
J U Hibbard1, M Tart, A H Moawad
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Chicago, Pritzker School of Medicine, Chicago, Illinois 60637, USA. jhibbard@babies.bsd.uchicago.edu
Obstetrics and Gynecology
|November 21, 2000
Summary
Transvaginal ultrasound measurement of cervical length between 16-22 weeks can identify pregnant individuals at higher risk for spontaneous preterm delivery. Shorter cervical length significantly increases the likelihood of delivering before 35 weeks gestation.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Diagnostic Ultrasound
Background:
- Spontaneous preterm delivery remains a leading cause of neonatal morbidity and mortality.
- Accurate identification of at-risk pregnancies is crucial for timely intervention.
- Cervical length measurement via transvaginal ultrasound is a potential screening tool.
Purpose of the Study:
- To evaluate the association between cervical length measured by transvaginal sonography and the risk of spontaneous preterm delivery.
- To determine if cervical length in asymptomatic gravidas at 16-22 weeks gestation can predict preterm birth.
Main Methods:
- Prospective observational study of 760 asymptomatic gravidas at 16-22 weeks gestation.
- Transvaginal ultrasound measurement of cervical length.
- Analysis of spontaneous preterm delivery before 37, 35, and 32 weeks.
- Logistic regression to control for confounding variables.
Main Results:
- Cervical length was normally distributed (mean 38.5 mm).
- Significantly increased relative risks (RR) for preterm delivery (before 35 weeks) were observed with shorter cervical lengths (e.g., RR 7.5 for 5th percentile).
- Cervical length was a significant independent predictor of preterm birth before 35 weeks.
Conclusions:
- Transvaginal cervical length measurement at 16-22 weeks is a valuable tool for identifying asymptomatic women at increased risk of spontaneous preterm delivery.
- This screening method can aid in targeted management strategies to improve perinatal outcomes.