Study Shows Mid-Trimester Cervical Length Not Predictive of Term Cesarean in Primiparous

   Cervical length at mid-trimester does not predict term cesarean delivery in primiparous women, according to the results of a study presented at the American College of Obstetricians and Gynecologists’ 59th Annual Clinical Meeting in Washington, D.C.

   It's widely recognized that a short cervix is associated with an increased risk of spontaneous preterm birth. To better understand the relationship, Parvinder K. Bola, MD, and colleagues at Lutheran Medical Center in Brooklyn analyzed the long cervix (>30mm) at mid-trimester and the risk of primary cesarean delivery in term primiparous singleton pregnancies.

   They studied 101 primiparous women with a cervical length >/=30mm at level 2 ultrasound, who delivered live born infants at term. Following data analysis, the investigators found that the rate of cesarean delivery at term was unaffected by cervical length for any quartile: low (<33mm), second (33-37mm), third (38-42mm), and fourth (>42.5mm), P=0.98. Logistic regression was used to determine the effect of age, gestational age, actual fetal weight, cervical length, gender, spontaneous or induced labor, birth weight percentile, and BMI on mode of delivery. Only maternal BMI had a statistically significant effect (P=0.002). The other variables were insignificant (P>0.17).

   Dr. Bola and his colleagues concluded that cervical length at mid-trimester is not a predictor of risk for cesarean delivery in primiparous women at term.