Antenatal cervical length measurement as a predictor of successful vaginal birth

Taha, Omima T.; Elprince, Mohamed; Atwa, Khaled A.; Elgedawy, Asmaa M.; Ahmed, Amira Y.; Khamees, Rasha E.

doi:10.1186/s12884-020-02878-z

Cited by 10 publications

(13 citation statements)

References 22 publications

(20 reference statements)

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“…14 Moreover, CL measurements play a major role in the prediction of labor . 15 Although standard measurements for uterine CL with increasing gestational age are not available yet, several studies have provided reference ranges (measured by TVUS) in large populations of women with singleton pregnancies . 16 An inverse relation between the uterine CL during pregnancy and the frequency of PTD has been reported .…”

Section: Introductionmentioning

confidence: 99%

Maternal BMI, 25-Hydroxyvitamin D serum level and Cervical Length Measurements: Markers for Preterm Delivery

Salem

ElTemamy²,

Ali

et al. 2021

Al-Azhar International Medical Journal

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Background: Preterm delivery is the delivery between 20th -37th weeks of gestation. Aim of the work: to study the maternal BMI, 25-Hydroxyvitamin D (25(OH)D) serum level, and uterine cervical length (CL) as predicting factors for PTD. Patients and methods: A prospective study included 188 pregnant women recruited during 20th -24th weeks of gestation. The maternal BMI was calculated, the serum level of 25(OH)D was measured, and the uterine CL was measured via transabdominal and transvaginal ultrasound. All women followed until delivery time and then were divided into 2 groups; group1 (n=54) women who delivered preterm, and group2 (n=134) women who delivered at term. Results: BMI results showed statistical significance between women who delivered preterm and those who delivered at term (29.7±1.7 vs. 23.6±2.2 kg/m2, P<0.001). Serum 25(OH)D showed no significant difference between the studied groups. CL was significantly shorter in women who delivered preterm than other group (32.39±5.93 vs. 44.42±4.17 mm, P<0.001). At 25 mm as a cut-off value for CL, the sensitivity, specificity, PPV, and NPV were 90.7%, 78.4%, 62.8%, and 95.5%, respectively. Women with BMI >25kg/m2 had significantly longer cervix than those who had BMI <25kg/m2. Regarding the effect of CL on the mode of delivery, 65.4% of women with CL <25 mm delivered vaginally. Conclusion: Maternal BMI had a significant relation with PTD. Measuring the CL during 20th -24th weeks helps predict preterm delivery and the mood of delivery. There is an association between BMI and cervical length.

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Section: Introductionmentioning

confidence: 99%

Maternal BMI, 25-Hydroxyvitamin D serum level and Cervical Length Measurements: Markers for Preterm Delivery

Salem

ElTemamy²,

Ali

et al. 2021

Al-Azhar International Medical Journal

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“…Prediction models for successful delivery through ultrasound include cervical length, angle of progression (AOP), fetal headperineum distance (HPD), fetal head-symphysis pubis distance (HSD), fetal head position before labor, sono-elastography, and shear wave velocity, which allow the assessment of cervical stiffness in pregnancy [7]. Although studies on cervical length as a predictor of delivery mode have been conducted widely, the results are controversial [8][9][10][11][12]. Sonoelastography has been introduced recently and proven to be useful for predicting the outcome of induced labor; however, this technique it is unsuitable for general use because of expensive equipment and the requirement of high-level skills.…”

Section: Introductionmentioning

confidence: 99%

The Value of Posterior Cervical Angle as a Predictor of Vaginal Delivery: A Preliminary Study

et al. 2021

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Accurate prediction of failure to progress and rapid decision making regarding the mode of delivery can improve pregnancy outcomes. We examined the value of sonographic cervical markers in the prediction of successful vaginal delivery beyond 34 weeks of gestation. A retrospective chart review was carried out. Medical information of singleton gestations delivered at a single center from 1 July 2019 to 30 August 2020 was collected. Transvaginal sonographic records of cervical length, anterior and posterior cervical angles, and cervical dilatation were obtained and re-measured. The value of these markers and clinical characteristics of mother and baby on vaginal delivery were investigated and compared to women who underwent cesarean section. A total of 90 women met the inclusion criteria. The rate of vaginal delivery was 75.6%. There were no differences found in terms of maternal age, rate of abortion, induction of labor, premature rupture of membranes, preterm labor, hypertension, diabetes, cervical length, and neonatal sex and weight. The prediction of vaginal delivery was provided by parity, maternal body mass index, and posterior cervical angle. The area under the receiver operating characteristic curve for prediction of vaginal delivery was 0.667 (95% CI 0.581–0.864, p = 0.017) for the posterior cervical angle, with a cutoff of 96.5°. Regression analysis revealed a posterior cervical angle ≥96.5° in the prediction of vaginal delivery (adjusted odds ratio: 6.24; 95% confidence interval: 1.925–20.230, p = 0.002). Posterior cervical angle ≥96.5° is associated with successful vaginal delivery. It is simple and easy to measure and can be useful in determining the mode of delivery.

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“…Another significant predictor is parity, whereby our study showed that one previous vaginal delivery will increase the odds of having a successful induction by 2.7 times. This was also an established independent factor from other published studies [12,26,28,29].…”

Section: Discussionmentioning

confidence: 69%

Pre-induction cervical assessment using transvaginal ultrasound versus Bishops cervical scoring as predictors of successful induction of labour in term pregnancies: A hospital-based comparative clinical trial

et al. 2022

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Objective To evaluate the association between transvaginal ultrasound scan of cervix and Bishop’s score in predicting successful induction of labour, cut-off points and patients’ tolerability and acceptance for both procedures. Design A comparative clinical trial. Setting A tertiary hospital in Selangor, Malaysia. Participants 294 women planned for elective induction of labour for various indications were included. All women had transvaginal ultrasound to assess the cervical length and digital vaginal examination to assess the Bishop cervical scoring by separate investigators before induction of labour. Primary outcome measure To evaluate the association of the cervical length by transvaginal ultrasound scan and Bishop score in predicting successful induction of labour. Secondary outcome measure Variables associated with successful induction of labour and patients’ tolerability and acceptance for transvaginal ultrasound scan of cervix. Results There was no statistically significant difference among the vaginal and Caesarean delivery groups in terms of mean maternal age, height, weight, body mass index, ethnicity and gestational age at induction. Vaginal delivery occurred in 207 women (70.4%) and 87 women (29.6%) delivered via Caesarean section. There was a high degree of correlation between the cervical length and Bishop score (r-value 0.745; p <0.001). Sonographic assessment of cervical length demonstrated a comparable accuracy in comparison to Bishop score. Analysis using ROC curves noted an optimal cut-off value of ≤27mm for cervical length and Bishop score of ≥ 4, with a sensitivity of 69.1% vs 67%, specificity 60.9% vs 55%, and area under the curves (AUCs) of 0.672 and 0.643 respectively (p <0.001). Multivariate logistic regression analysis demonstrated that parity (OR 2.70), cervical length (OR 0.925), Bishop score (OR 1.272) and presence of funnelling (OR 3.292) were highly significant as independent predictors of success labour induction. Women also expressed significantly less discomfort with transvaginal ultrasound compared with digital vaginal examination. Conclusion Sonographic assessment of cervical measurement predicts the success of induction of labour with similar diagnostic accuracy with conventional Bishop score.

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Antenatal cervical length measurement as a predictor of successful vaginal birth

Cited by 10 publications

References 22 publications

Maternal BMI, 25-Hydroxyvitamin D serum level and Cervical Length Measurements: Markers for Preterm Delivery

Maternal BMI, 25-Hydroxyvitamin D serum level and Cervical Length Measurements: Markers for Preterm Delivery

The Value of Posterior Cervical Angle as a Predictor of Vaginal Delivery: A Preliminary Study

Pre-induction cervical assessment using transvaginal ultrasound versus Bishops cervical scoring as predictors of successful induction of labour in term pregnancies: A hospital-based comparative clinical trial

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