Obstet Gynecol Sci.  2020 Jan;63(1):35-41. 10.5468/ogs.2020.63.1.35.

Can the cervical length in mid-trimester predict the use of vacuum in vaginal delivery?

• Park JY
• Kim SM
• Sohn J
• Kim S
• Song E
• Kim BJ
• Jeon HW

• KMID: 2467930
• DOI: http://doi.org/10.5468/ogs.2020.63.1.35

Abstract

OBJECTIVE
This study aimed to evaluate whether an increased cervical length (CL) measured in the mid-trimester is associated with vacuum-assisted vaginal delivery.
METHODS
This retrospective cohort study included women who delivered vaginally in Seoul National University Bundang Hospital (n=820) and Boramae Medical Center (n=509) between January 2017 and February 2019. Multifetal pregnancies and preterm births before 37 weeks of gestation were excluded. Only those cases in which CL was measured at 18-22 weeks of gestation for the purpose of screening for preterm birth risk in each institution were analyzed (n=537). Other significant risk factors were reviewed.
RESULTS
The median gestational age at delivery was 39.4 weeks (range, 37.0-41.6 weeks); 18.6% (100/537) were vacuum-assisted delivery. There was no relationship between mid-trimester CL and vacuum-assisted delivery (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.57-1.62), while nulliparity was associated with a higher risk (OR, 3.64; 95% CI, 1.55-8.57) than multiparity. When the population was divided into 3 groups by CL range, vacuum-assisted delivery rates increased as CL length increased in nulliparous women.
CONCLUSION
Mid-trimester CL did not predict the need for vacuum-assisted vaginal delivery.

Keyword

Vacuum extraction; Operative birth; Delivery; Cesarean section

MeSH Terms

Cesarean Section
Cohort Studies
Female
Gestational Age
Humans
Mass Screening
Parity
Pregnancy
Premature Birth
Retrospective Studies
Risk Factors
Seoul
Vacuum*

Figure

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  Fig. 1 Flowchart of the study population.SNUBH, Seoul National University Bundang Hospital; BMC, Boramae Medical Center.

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  Fig. 2 Proportion and odds ratios (ORs) of vacuum-assisted delivery by mid-trimester cervical length in nulliparous women (adjusted for oxytocin use).CI, confidence interval; Ref., reference value.

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