Transvaginal sonographic cervical length during mid-trimester in predicting preterm labour in asymptomatic singleton pregnancies


  • Shamshad Begum Mahammad Department of Gynecology & Obstetrics, MIMS, Vizianagaram, Andhra Pradesh, India
  • Nagamani Sunkireddy Department of Gynecology & Obstetrics, MIMS, Vizianagaram, Andhra Pradesh, India
  • Jayalakshmi M. Department of Gynecology & Obstetrics, MIMS, Vizianagaram, Andhra Pradesh, India



TVS, Cervical length, Preterm labour


Background: Worldwide, preterm birth is the main contributor to perinatal mortality and morbidity. Preterm birth causes 50% of long-term morbidity, contributes 75% of neonatal deaths (after accounting for fatal abnormalities), and becomes 85% of newborn deaths. Cervical length measurement has been linked to predicting the preterm labour in mid-trimester by various studies.

Methods: This study was carried out to evaluate the strength of cervical length as a predictive factor for pre-term labour. This is a prospective observational study conducted at MIMS, Vizianagaram on 100 antenatal mothers. The cervical length is measured by transvaginal ultrasound. If the length was <25 mm, then the patients were advised a second scan during 28th week and follow-up was done till delivery.

Results: Out of the 100 patients, 21 were multigravida, whereas 79 were primigravida. 20 had pre-term delivery and 80 had term delivery. The mean age of the population was 25.2±4.5 years. 40% of cases with cervical length <25 mm had pre-term delivery, as compared to 33.33% in patients with cervical length 26-30 mm, 13.63% in 31-35 mm, 5.88% in 36-40 mm and 16.66% in patients with cervical length >40 mm. The p value<0.05. Area under ROC curve is 0.79. Sensitivity is 60%, specificity is 8.75%, positive predictive value is 57.14%, negative predictive value is 89.87%.

Conclusions: Transvaginal sonography is a reliable diagnostic test in mid-trimester in predicting pre-term delivery in singleton pregnancy.


Gurung A, Wrammert J, Sunny AK, Gurung R, Rana N, Basaula YN, et al. Incidence, risk factors and consequences of preterm birth - findings from a multi-centric observational study for 14 months in Nepal. Arch Public Health. 2020;78:64.

Suman V, Luther EE. Preterm Labor. StatPearls Treasure Island, FL: StatPearls Publishing; 2022.

Hudić I, Stray-Pedersen B, Tomić V. Preterm Birth: Pathophysiology, Prevention, Diagnosis, and Treatment. Biomed Res Int. 2015;2015:417965.

Romero R, Dey SK, Fisher SJ. Preterm labor: one syndrome, many causes. Science. 2014;345(6198):760-5.

Quinn JA, Munoz FM, Gonik B, Frau L, Cutland C, Mallett-Moore T, et al. Preterm birth: Case definition & guidelines for data collection, analysis, and presentation of immunisation safety data. Vaccine. 2016;34(49):6047-56.

Herbst A, Nilsson C. Diagnosis of early preterm labour. BJOG. 2006;113(3):60-7.

Gonik B, Creasy RK. Preterm labor: its diagnosis and management. Am J Obstet Gynecol. 1986;154(1):3-8.

Chatterjee J, Gullam J, Vatish M, Thornton S. The management of preterm labour. Arch Dis Child Fetal Neonatal Ed. 2007;92(2):88-93.

Okitsu O, Mimura T, Nakayama T, Aono T. Early prediction of preterm delivery by transvaginal ultrasonography. Ultrasound Obstet Gynecol. 1992;2(6):402-9.

O’Hara S, Zelesco M, Sun Z. Cervical length for predicting preterm birth and a comparison of ultrasonic measurement techniques. Australas J Ultrasound Med. 2013;16(3):124-34.

Crane JMG, Hutchens D. Use of transvaginal ultrasonography to predict preterm birth in women with a history of preterm birth. Ultrasound Obstet Gynecol. 2008;32(5):640-5.






Original Research Articles