First trimester cervical length is associated with mid-trimester loss

Abstract

Objective: To study the value of the cervical length (CL) measurement at 11–14 weeks in predicting second trimester miscarriage occurring at 16–24 weeks.

Methods: Prospective study in routine obstetric population using transvaginal ultrasound examination to measure the length of the endocervical canal at 11–14 weeks.

Results: The study group consisted of 2836 singleton pregnancies. Eleven (0.0038%) women miscarried between 16 and 24 weeks whereas 2825 delivered after 34 weeks. CL was significantly shorter (Mann–Whitney U test, p = 0.001), in women that had a second trimester miscarriage in comparison to those who delivered after 34 weeks (median CL 28 mm versus 32 mm, respectively). First trimester CL was predictive of a late miscarriage (OR = 0.7093304, R²= 0.1211, AUC = 0.7838, p < 0.001). The detection rate was 63.64% for 20% screen positive rate.

Conclusions: First trimester endocervix is significantly shorter in women destined to miscarry between 16 and 24 weeks. In low risk singleton pregnancies, first trimester CL can be useful in predicting second trimester miscarriage.

• Cervix
• first trimester ultrasound
• late miscarriage
• mid-trimester loss
• screening

Acknowledgements

We would like to acknowledge the contribution of Ms. Chara Euripioti (Research Midwife) and Mr. Christos Parthenis (Resident Doctor), in the initial outcome’s data collection.

Declaration of interest

The authors report no conflicts of interest.