Prediction of Preterm Birth by Second Trimester Transvaginal Ultrasound Measurement of Cervical Length. A Prospective Observational Study at a Tertiary Care Hospital

Abstract

Objective: To determine the predictive value of second-trimester transvaginal ultrasound measurement of
cervical length for preterm birth.
Study Design: Prospective observational study.
Place and Duration of Study: This study was conducted at the Department of Obstetrics and Gynecology, Pak
Emirates Military Hospital (PEMH), Rawalpindi, Pakistan, a tertiary care facility from April 2023 to September
2023.
Methods: After obtaining written informed consent, 132 pregnant women who met the selection criteria were
enrolled. All patients underwent transvaginal ultrasonographic evaluation during the 20^th to 24^th week. A
consultant gynaecologist assessed cervical length three times. The smallest measurement was noted down,
and it was further confirmed by a consultant radiologist. All patients were followed up until delivery, and
preterm birth was assessed; findings were analyzed statistically. No intervention was done during this study.
Results: The mean age of the patients was 28.5 ± 3.91 years. Cervical shortening (<2.5cm) was seen in 24
(18.2%) patients. Overall, pre-term birth occurred in 27 (20.5%) patients. In patients with cervical shortening,
preterm birth occurred in 16 (66.7%) patients. A statistically significant relation existed between cervical
shortening and preterm birth (P=0.000). The sensitivity, specificity, PPV, and NPV of cervical shortening for
determining preterm birth were 59%, 92.5%, 66.5%, and 89.9%, respectively. The Chi-square value was 38.47,
which shows a statistically significant relationship between cervical shortening and preterm birth. In other
words, cervical is strongly associated with a higher risk of preterm birth in this population.
Conclusion: Cervical length measured by TVS during the second trimester had a moderately high predictive
value and specificity for predicting preterm birth.

How to cite this: Kousar R, Iftikhar B, Khan FS, Kousar R, Mahmood F, Shahzadi H. Prediction of Preterm Birth by Second Trimester Transvaginal Ultrasound Measurement of Cervical Length. A Prospective Observational Study at a Tertiary Care Hospital. Life and Science. 2025; 6(2): 223-229. doi: http://doi.org/10.37185/LnS.1.1.850