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Association between second-trimester cervical length and primary cesarean delivery.

Emily S Miller1, Allie Sakowicz, William A Grobman

  • 1Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

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Increased second-trimester cervical length in nulliparous women is linked to a higher rate of cesarean delivery. This finding suggests cervical length may be a factor in predicting delivery outcomes.

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Area of Science:

  • Maternal-fetal medicine
  • Obstetrics
  • Pregnancy outcomes

Background:

  • Second-trimester cervical length is routinely measured during pregnancy screening.
  • The relationship between cervical length and delivery mode requires further investigation.

Purpose of the Study:

  • To determine if a longer second-trimester cervical length is associated with an increased rate of cesarean delivery in nulliparous women.

Main Methods:

  • Retrospective cohort study of nulliparous women with singleton pregnancies.
  • Women were grouped by second-trimester cervical length quartiles.
  • Cesarean delivery rates were analyzed using univariable and multivariable models.

Main Results:

  • Each centimeter increase in cervical length correlated with a 20.3% rise in cesarean delivery odds.
  • Cesarean delivery frequency increased with higher cervical length quartiles (17.4% to 27.7%).
  • This association remained significant after adjusting for gestational age and labor induction, primarily driven by labor arrest disorders.

Conclusions:

  • A longer second-trimester cervical length is associated with a higher incidence of primary cesarean delivery in nulliparous women.
  • Cervical length may serve as a predictive marker for cesarean delivery risk.