Prediction of Delivery Term Through Systematic Measurement of Cervical Length between 18 and 24 Weeks of Gestation: Predictive Value and Clinical Application

Abstract

Introduction: Preterm birth is a major cause of neonatal morbidity and mortality. This study aims to evaluate the predictive value of cervical length measurement between 18 and 24 weeks of gestation for predicting the delivery term. Methods: This is a prospective, observational, multicenter study conducted at the "G26" and Service A of a maternity and neonatal center in Tunis. Sixty asymptomatic patients were included. Results: The preterm birth rate was 38.3%. The average age of the patients was 30.9 years, and the average BMI was 27.2. The majority of the patients (61.7%) were of middle socioeconomic status. Notably, 25% were smokers, with 66.7% of them delivering preterm (p<0.001). Primiparity accounted for 56.8%. The average cervical length (CL) was 30.3 ± 11.1 mm. A short cervix (<25 mm) was found in 31.7% of the patients. The average duration between cervical measurement and delivery was 66.9 days. Approximately 48.3% of the patients received progesterone, and 6.7% were treated with a pessary. A strong correlation between cervical length and delivery term was observed (Spearman's correlation coefficient of 0.86; p < 0.001). Seventy percent of patients with a cervical length <15 mm delivered before 34 weeks of gestation, while 89.2% with a cervical length >30 mm delivered at term. A cervical length threshold of 25 mm demonstrated a sensitivity of 82.6% and a specificity of 100%. The area under the curve was 0.99. Conclusion: Systematic cervical length measurement is an effective method for identifying pregnancies at risk of preterm birth. Further multicenter studies are needed to confirm these results.