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Cervical length at 11-40 weeks: unconditional and conditional longitudinal reference ranges.

Ioannis Papastefanou1,2, Athanasios Pilalis1,2, Dimitra Kappou2

  • 1Fetal Medicine Unit, Leto Maternity Hospital, Athens, Greece.

Acta Obstetricia Et Gynecologica Scandinavica
|September 18, 2016
PubMed
Summary

This study establishes new reference ranges for cervical length during pregnancy using ultrasound measurements. These findings enable personalized cervical length assessments throughout gestation for better monitoring.

Keywords:
Cervixlongitudinal rangesmultilevel modelingpregnancypreterm birthtransvaginal ultrasound

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Area of Science:

  • Obstetrics and Gynecology
  • Fetal Medicine
  • Medical Imaging

Background:

  • Cervical length is a critical indicator in pregnancy.
  • Existing reference ranges may not fully capture longitudinal changes.
  • Accurate assessment requires gestational age-specific data.

Purpose of the Study:

  • To establish unconditional and conditional longitudinal reference ranges for cervical length.
  • To develop personalized cervical length charts based on gestational age.
  • To improve the accuracy of cervical length assessment during pregnancy.

Main Methods:

  • Prospective longitudinal study design.
  • Transvaginal ultrasound for repeated cervical length measurements.
  • Multilevel modeling (linear mixed-effects model) applied to 13,765 measurements from 4,397 women.

Main Results:

  • Developed unconditional longitudinal reference charts for cervical length from 11 to 40 weeks gestation.
  • Demonstrated a negative non-linear association between mean cervical length and gestational age.
  • Calculated terms for constructing personalized, conditional cervical length charts.

Conclusions:

  • Longitudinal reference charts for cervical length in singleton pregnancies were successfully created.
  • Cervical length assessment should be adjusted for gestational age using these new ranges.
  • Personalized cervical assessment is feasible with conditional charts, enhancing clinical utility.