The role of dynamic cervical change (spontaneous real-time cervical shortening) in prediction of preterm birth

Introduction and aim: To determine prospectively if dynamic cervical change (spontaneous real-time cervical shortening) is predictive of preterm delivery at <37 weeks' gestation in patients with and without symptoms of preterm labor. Materials and methods: It was planned to investigate the role of transvaginal Ultrasonografiography (TVUSG) and cervical length measurements in the prediction of preterm labor in singleton pregnant women between 20-34 weeks of gestation who applied to Aydın Adnan Menderes University Medical Faculty Application and Research Hospital Gynecology and Obstetrics Service or outpatient clinic. A total of 5 cervical length measurements were performed at 2.5-minute intervals in a 10-minute period in singleton pregnancies at 20-34 weeks with and without preterm labor symptoms. Pregnant women with preterm premature rupture of membranes, cervical dilatation more than 3 cm, or those with cervical cerclage were not included in the study. All cervical length measurements were recorded. The difference between the first cervical length, the shortest cervical length, the maximum cervical length, and the maximum - minimum cervical length was evaluated as "dynamic cervical change". The mean dynamic cervical change of all pregnant women was calculated as 7.3 mm and above this value was accepted as dynamic cervical change. Symptomatic and asymptomatic pregnant groups were compared according to their dynamic cervical changes. Gestational week at birth was obtained from medical records. Results: It was observed that all cervical length measurements were shorter in the symptomatic pregnant group than in the asymptomatic pregnant group. According to the results of our study examining dynamic cervical changes in pregnant women with and without preterm labor symptoms, although dynamic cervical change (7,3 mm) is more common in symptomatic pregnant women, it is not thought to contribute to the prediction of preterm delivery. When the dynamic cervical change value (4 mm) in the literature is taken as reference; dynamic cervical change was found to be more significant in predicting preterm labor in asymptomatic pregnant women compared to symptomatic pregnant women. There is a need for more comprehensive studies on the prediction of preterm birth by dynamic cervical change. Key Words: Cervical length, Dynamic cervical change, Preterm birth, Transvaginal Ultrasonography (TVUSG).