PREDICTION OF SPONTANEOUS PRETERM BIRTH BY CERVICAL LENGTH MEASUREMENT

Dr. Anju Vijayan, *Dr. Beenakumari R. and Dr. Kala B. S.

ABSTRACT

Introduction: Spontaneous preterm birth is a global problem leading to significant perinatal morbidity and mortality. Cervical length measurement is one of the methods of prediction of preterm birth. Materials & Methods: This prospective observational study was conducted at Department of Obstetrics & Gynecology, Government Medical College, Kottayam, Kerala for 18 months from March 2018. 400 uncomplicated primigravid patients were included. Cervical length was measured at 11-14 weeks and at 20 weeks of gestation. Reduction in cervical length between these two gestations were noted. Patients were grouped into cervical length reduction of < 1 cm and ≥ 1 cm. Gestational age at delivery was observed. Results: The mean age of the study group was 27.26 years. The rate of spontaneous preterm birth was 21 %.The mean cervical length at 11 – 14 weeks was 3.88 cm and that at 20 weeks was 3. 46 cm. Cervical length at 20 weeks and a reduction of cervical length of ≥ 1 cm from 11 – 14 weeks were significantly associated with spontaneous preterm birth. Using receiver operative characteristic (ROC) curve analysis at 20 weeks, a cervical length reduction cut off value > 0.6 cm had a specificity of 80.7% and sensitivity of 44.05% in prediction of spontaneous preterm birth. Conclusion: The cervical length measurement at 11 – 14 weeks and 20 weeks along with routine obstetric ultrasound can help in identification of patients at risk for spontaneous preterm birth.

Keywords: Preterm birth; Pregnancy; Cervical length.