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Ultrasound assessment of cervical length in prolonged pregnancy: prediction of spontaneous onset of labor and successful vaginal delivery
Author(s) -
Vankayalapati P.,
Sethna F.,
Roberts N.,
Ngeh N.,
Thilaganathan B.,
Bhide A.
Publication year - 2008
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.5254
Subject(s) - medicine , obstetrics , pregnancy , logistic regression , parity (physics) , vaginal delivery , gynecology , cervical dilatation , transvaginal ultrasound , ultrasound , cervix , radiology , genetics , physics , particle physics , cancer , biology
Objectives To evaluate the usefulness of sonographic assessment of cervical length in the prediction of spontaneous onset of labor and of vaginal delivery. Methods Two hundred and six women who attended a dedicated postdates clinic at 41 + 3 weeks of pregnancy and agreed to the assessment of cervical length using transvaginal ultrasound imaging were included in the study. Those who had not delivered at 42 weeks were offered induction of labor. The labor details were recorded prospectively, and the onset of spontaneous labor and mode of delivery were correlated with cervical length data. Results Women who underwent spontaneous onset of labor ( n = 112) had a significantly shorter cervical length (mean (SD) 25.0 (8.3) mm) than had women whose labor was induced ( n = 67; mean (SD) 29.7 (8.5) mm). Logistic regression analysis showed that cervical length was an independent predictor of the likelihood of spontaneous labor in nulliparous women, and of vaginal delivery in both nulliparous and parous women. Parity had no independent effect on the onset of spontaneous labor, but was an independent predictor of the likelihood of vaginal delivery. Conclusions Sonographic assessment of cervical length is a significant independent predictor of the likelihood of the onset of spontaneous labor in nulliparous women, and of successful vaginal delivery in both nulliparous and parous women with prolonged pregnancy. Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd.