Relationship between Sonographic Measurement of Cervical Length at 37 Weeks of Gestation and Outcome of Vaginal or Cesarean Delivery

Document Type : Original Article

Authors

1 Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.

2 Graduate of Obstetrics and Gynecology Residency, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.

3 Professor, Department of Community Medicine, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.

4 Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.

5 Associate Professor, Department of Midwifery Consultation, Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.

10.22038/ijogi.2025.85597.6338

Abstract

Introduction: Unplanned (emergency) cesarean section during the natural delivery process may result in increased maternal and fetal complications. The present study was conducted with aim to investigate the predictive role of cervical length based on sonographic measurement at 37 weeks of pregnancy in vaginal or cesarean delivery.
Methods: This dignostic assessment study was conducted on 248 pregnant women referred to kowsar hospital, Qazvin between June 2022 and March 2023. Transvaginal ultrasound measurement of cervical length was performed at 37 weeks of pregnancy, and then the type of delivery was recorded as vaginal or cesarean. Data were analyzed by SPSS software (version 27) and Chi-square and Independent t-tests and ROC curve. P<0.05 was considered significant.
Results: The mean cervical length at 37 weeks of pregnancy in women who underwent cesarean section was significantly greater than in women who delivered vaginally (24.11 vs. 22.02 mm). At the cutoff point of 21.5 mm, sensitivity, specificity, positive and negative predictive values, and overall accuracy of cervical length in diagnosing cesarean section were 75%, 48.9%, 37.5%, 82.7%, and 56.45%, respectively. The frequency of cesarean section was significantly higher in women with a cervical length greater than 21.5 mm than in women with a cervical length less than 21.5 mm (37.5% vs. 17.3%), and having a cervical length greater than 21.5 mm at 37 weeks increased the likelihood of cesarean section with an odds ratio of 2.86.
Conclusion: Cervical length at 37 weeks of pregnancy can be used as a factor to predict cesarean section, but this factor has low diagnostic power (in terms of specificity) and should be used in conjunction with other diagnostic methods.

Keywords

Main Subjects

References

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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 28, Issue 10
December 2025
Pages 11-23

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