TITLE:
Correlation between Endocervical Length in the First Trimester and Spontaneous Preterm Delivery
AUTHORS:
Korine Camargo de Oliveira, Mariana Menegon de Souza, Patricia Telló Dürks, Maria Alexandrina Zanatta, Eduardo Becker Jr., Janete Vettorazzi
KEYWORDS:
Preterm Birth, Screening, Cervical Length Measurement, Preterm Birth Prevention Clinic
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.11,
November
24,
2021
ABSTRACT: Introduction: Prematurity is a public health problem in Brazil, with 12% of deliveries
occurring before 37 weeks of gestation. The measurement of the cervix in the
second trimester is already established as a method of screening for
prematurity and some studies point out advantages to start this screening in
the first trimester. Objective: To define the correlation between the
length of the endocervix by transvaginal ultrasound in the first trimester (11
to 14 weeks) with spontaneous early deliveries. Method: A prospective
and observational study realized in a suplementar and private ultrasound clinic
and hospital of Porto Alegre, Brazil between 2019-2020. Ultrasound screening of
cervix was performed in singleton pregnancies in first and second trimester of
pregnancy and correlated with age of delivery. Results: 142 pregnant
women were studied, 80% were in the first pregnancy. The average age was 33.8
years. The rate of prematurity was 18% before 37 weeks and 4% before 34 weeks.
The average of cervix measured in the first and second trimesters in deliveries
before 34 weeks was 32.7 mm and 29.3 mm, respectively. In term deliveries the
median cervical length was 38.8 mm and 37.8 mm, respectively. When analyzing
the measurements of the cervix in the second trimester, the cervix was smaller
(p = 0.008) among deliveries below 34 weeks (29 mm) than
deliveries after 37 weeks. No statistically related differences were found
between preterm birth and first trimester cervix measurements. Conclusions:
In this study, we did not observe a statistically significant relationship
between first trimester cervix measurement and prematurity. More studies are
needed to evaluate this finding. However, the measurement of the cervix in the
second trimester is different from that found in the literature. This suggests a
possible new cut-off point that increases the sensitivity of transvaginal
ultrasound as a method of preventing prematurity.