Predicting mode of delivery using mid‑pregnancy ultrasonographic measurement of cervical length among nulliparous women

Abstract

Background: Numerous studies have demonstrated that measuring the cervical length using transvaginal ultrasonography in singleton pregnancies at 20-24 weeks gestation can be a valuable technique for predicting the likelihood of a severe preterm birth. The association between cervical length at 20-24 weeks and the likelihood of a term cesarean section birth has, however, not been well researched. The purpose of this research is to ascertain if mid-pregnancy ultrasonography cervical length measurements are effective in anticipating term cesarean sections. Our hypothesis in this study is that there is no correlation between mid-pregnancy cervical length and the chance of a cesarean section during term labor. Methods: One hundred pregnant women, ranging in gestation from twenty to twenty-four weeks, were enrolled in the study. Individuals were chosen from the prenatal outpatient clinic. The gestational age varied from 36 to 40 (38.7±2.2 weeks). Of the cases, 53 women (53%) had a normal birth, and 47 women (47%) had a cesarean section. Four sets of data were identified based on the cervical length quartile: first quartile (15-24 mm), second quartile (25-29 mm), third quartile (30-39 mm), and fourth quartile (40-50 mm). Results: Patients with cervical lengths in the second quartile (18.2%) had the lowest rate of cesarean sections (18.6%), whereas patients with cervical lengths in the fourth quartile (96.6%) had considerably higher rates (p<0.00). Patients in the fourth quartile had a substantially higher (p<0.00) frequency of cesarean sections due to labor failure (6.38%). Logistic regression analysis revealed that the odds ratio (OR) for cesarean section in labor was lowest among patients in the first quartile (OR=1.94) and highest among patients in the fourth quartile (OR=2.95). The cervical length quartile did not significantly differ in terms of neonatal outcomes, with exception of birth weight, which did significantly differ. Conclusions: For patients who are nulliparous, the cervical length measured by transvaginal ultrasonography at mid-gestation can be used to predict the chance of a cesarean delivery at term