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Second trimester cervical length and prolonged pregnancy (.).

Rupsa C Boelig1, Kelly M Orzechowski2, Anju Suhag3

  • 1a Division of Maternal Fetal Medicine , Department of Obstetrics & Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University , Philadelphia , PA , USA .

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|March 9, 2016
PubMed
Summary
This summary is machine-generated.

A longer second-trimester cervical length (CL) in nulliparous women increases the risk of prolonged pregnancy. However, CL measurement alone is not a reliable predictor for identifying pregnancies likely to go past the due date.

Keywords:
Cervical lengthlate term pregnancypost term pregnancyprolonged pregnancy

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Diagnostic Ultrasound

Background:

  • Second-trimester cervical length (CL) is a known predictor for preterm birth.
  • Its association with prolonged pregnancy is less understood.
  • Nulliparous women reaching term with planned vaginal delivery represent a key population for evaluating predictive markers.

Purpose of the Study:

  • To investigate the association between second-trimester transvaginal ultrasound cervical length (CL) and the incidence of prolonged pregnancy (≥41 0/7 weeks).
  • To assess the predictive value of CL for prolonged pregnancy in nulliparous women reaching at least 37 weeks gestation with a planned vaginal delivery.

Main Methods:

  • Retrospective cohort study of nulliparous singleton pregnancies (18 0/7–23 6/7 weeks gestation).
  • Included women who delivered at term (≥37 weeks) spontaneously or reached 41 weeks.
  • Analyzed risk of prolonged pregnancy by CL quartiles using adjusted odds ratios (aOR) and receiver operating characteristic (ROC) curves.

Main Results:

  • A total of 722 women were included; 24% experienced prolonged pregnancy.
  • Increased risk of prolonged pregnancy was observed with longer CL, with a CL ≥37 mm associated with a two-fold increased risk (aOR 2.17).
  • ROC curve analysis did not identify a specific CL cutoff predictive of prolonged pregnancy (AUC 0.544, p=0.079).

Conclusions:

  • A longer second-trimester cervical length is associated with an increased risk of prolonged pregnancy in nulliparous women.
  • However, cervical length measurement alone is not sufficiently predictive to identify pregnancies likely to extend beyond the due date.