Association between second-trimester cervical length and cesarean delivery in multiparas

Objectives-The purpose of this study was to determine whether there is an association between second-trimester cervical length and cesarean delivery in women with a prior vaginal delivery.

Methods-We conducted a retrospective cohort study of multiparous women with singleton gestations who underwent routine cervical length screening between 18 and 24 weeks' gestation and labored after 34 weeks. Cervical lengths were divided into quartiles, and the frequency of cesarean delivery was compared across the groups. Indications for cesarean delivery were also compared. A multivariable logistic regression was performed with cervical length as a categorical and a continuous variable to adjust for potential confounders.

Conclusions-The second-trimester cervical length quartile in multiparas is not associated with an increased frequency of cesarean delivery. This finding differs from studies of nulliparas.

Results-Of the 2260 multiparas who met inclusion criteria, 63 (2.8%) underwent a cesarean delivery. We observed no association between the second-trimester cervical length quartile and the frequency of cesarean delivery (2.1%, 3.5%, 2.3%, and 3.1%, respectively; P = .434). Further analysis using cervical length as a continuous variable and controlling for potential confounding variables did not change this result (adjusted odds ratio, 1.08; 95% confidence interval, 0.80-1.46).