Cervical length at 11-14 weeks' and 22-24 weeks' gestation evaluated by transvaginal sonography, and gestational age at delivery.
OBJECTIVE
To compare cervical length measurements obtained at 11 to 14 weeks and 22 to 24 weeks of gestation in an unselected group of pregnant women and to correlate the measurements with time of delivery.


METHODS
This was a prospective study involving 529 pregnant women attending for routine antenatal care who underwent transvaginal scans at 11-14 weeks and 22-24 weeks for evaluation of cervical length. The mean cervical length was calculated at both stages of gestation and lengths were compared between groups which delivered at term or prematurely, this being defined as delivery before 37 completed weeks of gestation.


RESULTS
The mean cervical lengths at 11-14 and 22-24 weeks were, respectively, 42.4 mm and 38.6 mm. Cervical length at 11-14 weeks was not significantly different between the groups which delivered at term (42.7 mm) and preterm (40.6 mm). However, at the 22-24-week evaluation, cervical length was significantly shorter in the group which had a preterm delivery than in that which had a term delivery (26.7 mm and 39.3 mm, respectively; P = 0.0001). In the group of women with a previous history of one or more preterm deliveries, there was a greater shortening in cervical length from the first to the second evaluation than there was in the group of women with no previous history of preterm delivery. This shortening was also more pronounced in the group which delivered prematurely (from 40.6 mm to 26.7 mm) than in that which delivered at term (from 42.7 mm to 39.3 mm).


CONCLUSIONS
There is a spontaneous shortening in the pregnant cervix from the first to the second trimester of pregnancy. The shortening is more rapid in pregnant women who deliver prematurely and who have a history of previous preterm delivery.
Carvalho
M H B
MH
Department of Obstetrics, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Brazil.
Bittar
R E
RE
Brizot
M L
ML
Maganha
P P S
PP
Borges da Fonseca
E S V
ES
Zugaib
M
M
D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008875:Middle Aged; D007752:Obstetric Labor, Premature / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000379:methods*