Abstract: Objective: To study the prediction of preterm labour by measurement of cervical length in first trimester (11 to 13+6 weeks) and second trimester (20 to 24 weeks) by using TVS.
Material and Method: This longitudinal prospective study conducted at govt. medical college hospital and JK Lon hospital Kota the Fetal. Our policy is to offer routine sonographic examinations at 11 to 13+6days and 20 to 24 weeks’ gestation as part of a 2- stage screening program for chromosomal and structural abnormalities. All women with viable singleton pregnancies requesting risk assessment for chromosomal abnormalities at 11 to 13+6 days by nuchal translucency measurement and maternal serum biochemistry were offered measurements of cervical length by transvaginal sonography at 11 to 13+6 weeks (Cx1), and 20 to 24 weeks (Cx2). Maternal demographic characteristics, the obstetric history, and the history of cervical surgery were recorded during the first visit. Primigravida, miscarriage before 16 gestational weeks, preterm delivery before 34 weeks, preterm delivery before 37 weeks, and term delivery.
Result: In our study, mean age of study participants was 23.9 years with SD of 4.2 years. In the present study, mean gestational age at the time delivery was 35.9 weeks and its range 28 to 41 weeks. In our study, mean POG for 1st cervical length measurement was 12.1 weeks and mean cervical length was found to be 3.47 cm and mean POG for 2nd cervical length measurement was 22 weeks and mean cervical length was found to be 3.07 cm. Using ROC curve best cut off of cervical length at 11-13 weeks for preterm delivery is 3.3 cm and at 20-22 weeks is 3.0 cm. Sensitivity, Specificity, Positive predictive value and Negative predictive value to detect preterm delivery were 84.4%, 75.5%, 73.8% and 85.6% respectively at 11-13 weeks after taking cut off 3.0cm.
Conclusion: Our study concluded that there was significant difference in the cervical length in first trimester and second trimester among those who delivered term and preterm. Second trimester cervical length has a slight better positive predictive value, negative predictive value, specificity and sensitivity when compared to first trimester cervical length still we can predict more than 84% preterm delivery in first trimester by measurement of cervical length by transvaginal USG.
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