title: Second-trimester cervical length and outcomes of induction of labor at term.
abstract: OBJECTIVE
  To evaluate whether second-trimester cervical length (CL) is associated with induction of labor (IOL) outcomes.
  
  
  METHODS
  Retrospective cohort study of nulliparous singletons undergoing CL screening at 18 0/7-23 6/7 weeks from 1/1/2012 to 12/31/2013. Women induced at term (≥37 weeks) were included. Primary outcome was vaginal delivery (VD) within 24 h. The effect of CL on outcomes was assessed by incidence across CL quartiles and a receiver operating characteristics (ROC) curve. Odds ratios (OR) were adjusted (aOR) for confounders.
  
  
  RESULTS
  Two-hundred-and-sixty-eight women were included. Aside from a difference in incidence of prior cervical surgery between CL quartiles (p <. 02), other characteristics were similar. Ninety-two women (35%) had a VD within 24 h (versus a CD or VD >24 h). A longer a CL was associated with a decreased likelihood of a VD within 24 h with aORs of the third and fourth quartiles of 0.35 (0.16-0.75) and 0.43 (0.21-0.90), respectively, compared to the first quartile. A CL >40 mm was predictive of not having a VD within 24 h with a sensitivity of 56%, specificity of 58% and a positive predictive value of 72%.
  
  
  CONCLUSIONS
  A second-trimester CL >40 mm is associated with a decreased likelihood of VD within 24 h in an IOL.
authors.affiliation: a Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , Sidney Kimmel Medical College of Thomas Jefferson University , Philadelphia , PA , USA.
authors.forename: Rupsa C
authors.initials: RC
authors.lastname: Boelig
authors.affiliation: b Division of Maternal Fetal Medicine , Baylor College of Medicine , Houston , TX , USA.
authors.forename: Anju
authors.initials: A
authors.lastname: Suhag
authors.affiliation: c Department of Obstetrics and Gynecology , Thomas Jefferson University , Philadelphia , PA , USA.
authors.forename: Juliana
authors.initials: J
authors.lastname: Guarente
authors.affiliation: d Department of Maternal Fetal Medicine , Virginia Hospital Center , Arlington , VA , USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Orzechowski
authors.affiliation: a Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , Sidney Kimmel Medical College of Thomas Jefferson University , Philadelphia , PA , USA.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Berghella
mesh_terms: D000328:Adult; D054791:Cervical Length Measurement; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000706:statistics & numerical data*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D055815:Young Adult
keywords: Cervical length; delivery outcome; induction of labor