Clinical Efficacy of Cervical Length and Volume for Prediction of Labor Onset in VBAC Candidates

• Main Author: Yun Sung Jo, Gui Se Ra Lee, Narinay Kim, Dong Gyu Jang, Sa Jin Kim, Young Lee
• Format: Article
• Language: English
• Published: Ivyspring International Publisher 2012-01-01
• Series: International Journal of Medical Sciences
• Online Access: http://www.medsci.org/v09p0738.htm

<p><b>Background: </b>The purpose of this research is to discover whether measurement of cervical length and cervical volume at term is helpful in predicting the onset of labor in VBAC candidates.</p><p><b>Methods: </b>Transvaginal sonographic evaluations of the cervixes of pregnant women who desired to undergo VBAC were performed between 36 - 40 weeks gestation. Clinical information such as labor onset time, gestational age at delivery and delivery mode was gathered from medical records.</p><p><b>Results: </b>A total of 514 pregnant women participated in this study. Cervical length was significantly longer in the group that delivered 7 days or more after measurement than in the group that delivered within 7 days of measurement (43&#177;0.77 cm vs. 2.99&#177;0.72 cm, <i>p</i>&#60; 0.001). Cervical volume was significantly larger in the group that delivered at and after 7 days than in the group that delivered within 7 days (29.21&#177;11.62 cm³ vs. 34.07&#177;13.41 cm³, <i>p</i>=0.014). The cervical length ROC curve was significantly more predictive than the cervical volume ROC curve (AUC: 0.711 vs 0.594, <i>p</i>= 0.001). There were no significant differences between the combined cervical length/volume ROC curve and the cervical length ROC curve alone (<i>p</i>= 0.565). The AUC of the cervical length ROC curve to predict postterm pregnancy was 0.729.</p><p><b>Conclusion: </b>Measuring cervical length is helpful in predicting the onset of spontaneous labor within 7 days and posterm delivery in VBAC candidates.</p>