The Cervical Length Variation During Pregnancy at Patients with Previous Cesarean Scar

  • Șucu Roxana Romanian Journal of Emergency Surgery
  • I. Bordeianu Ovidius University, Constanța, Romania
Keywords: cesarean scar, cervical length, ultrasound, cesarean scar


Introduction. The purpose of the present study was to evaluate the consequences of repeated cesarean section and we focused on cervical length. We wanted to assess by ultrasound the correlation between caesarean scar and cervical length in patients with previous cesarean section.

Material and methods. We realized a prospective study at Bucur Maternity “St. John”, Hospital, Bucharest between 2016-2020 that included patients with cesarean scar who were monitored during pregnancy in our department. The patients were evaluated by ultrasound for the cervical length in each trimester of pregnancy and after birth.

Results. The study included 69 patients with cesarean scar aged between 18 and 41 years, with a mean age of 29.26 years. In the first trimester of pregnancy the mean value for cervical length was 35.48 mm (standard deviation 4.85, CI: [34.31; 36.64]). For women monitored in the second trimester, the length of the cervix recorded values was 33.11 mm (standard deviation 2.81, CI: [32.34; 33.87]). It is observed that women with uterine contractions in the 30-34 weeks of pregnancy, the length of the cervix measured in the second trimester is slightly shorter than in pregnant women without contractions. Thus, they had an average cervical canal length of 31.33 mm (standard deviation 2.00, CI: [29.80; 32.87]), respectively 34.44 mm (standard deviation 2.76, CI: [33.35; 35.54]).

Conclusions. Ultrasound evaluation of cervical length in the first trimester of pregnancy proved that cervix is shorter in older patients.Cervicometry in the second trimester of pregnancy registered lower values than compared with the first trimester.



Berghella V, Lockwood CJ, Barss VA. Repeat cesareandelivery.uptodate 05, 2016.
Marshall NE, Fu R, Guise JM. Impact of multiple cesarean deliveries on maternal morbidity: a systematic review. Am J ObstetGynecol 2011; 205:262.e1.
Cook JR, Jarvis S, Knight M, Dhanjal MK. Multiple repeat caesarean section in the UK: incidence and consequences to mother and child. A national, prospective, cohort study. BJOG 2013; 120:85.
Freedman G, Cean C, Duron V, et al. Pathogenesis and treatment of pain in patients with chronic wounds. Surg Technol Int 2003; 11:168.
Rossouw JN, Hall D, Harvey J. Time between skin incision and delivery during cesarean. Int J Gynaecol Obstet 2013; 121:82.
Morales KJ, Gordon MC, Bates GW Jr. Postcesarean delivery adhesions associated with delayed delivery of infant. Am J Obstet Gynecol 2007; 196:461.e1.
Eijsink JJ, van der Leeuw-Harmsen L, van der Linden PJ. Pregnancy after Caesarean section: fewer or later? Hum Reprod 2008; 23:543.
C Edward Wells,F Gary Cunningham. Choosing the route of delivery after cesarean birth.uptodate 06, 2016.
Baron J, Weintraub AY, Eshkoli T, Hershkovitz R, Sheiner E. The consequences of previous uterine scar dehiscence and cesarean delivery on subsequent births. Int J Gynaecol Obstet. 2014;126(2):120-122. doi:10.1016/j.ijgo.2014.02.022
Wang LL, Chen JY, Yang HX, et al. Zhonghua Fu Chan Ke Za Zhi. 2019;54(6):375-380. doi:10.3760/cma.j.issn.0529-567x.2019.06.004
Rossi AC, Prefumo F. Pregnancy outcomes of induced labor in women with previous cesarean section: a systematic review and meta-analysis. Arch GynecolObstet 2015; 291:273.
Barzilay E, Shay A, Lahav-Ezra H, et al. Sonographic assessment of the lower uterine segment during active labor in women with or without a uterine scar - a prospective study. J Matern Fetal Neonatal Med. 2018;31(14):1885-1888. doi:10.1080/14767058.2017.1331428
Middleton P, Shepherd E, Crowther CA. Induction of labour for improving birth outcomes for women at or beyond term. Cochrane Database Syst Rev. 2018;5(5):CD004945. Published 2018 May 9. doi:10.1002/14651858.CD004945.pub4
Kyrgiou M, Athanasiou A, Paraskevaidi M, et al. Adverse obstetric outcomes after local treatment for cervical preinvasive and early invasive disease according to cone depth: systematic review and meta-analysis. BMJ. 2016;354:i3633. Published 2016 Jul 28. doi:10.1136/bmj.i3633
Berghella V, Palacio M, Ness A, Alfirevic Z, Nicolaides KH, Saccone G. Cervical length screening for prevention of preterm birth in singleton pregnancy with threatened preterm labor: systematic review and meta-analysis of randomized controlled trials using individual patient-level data. Ultrasound Obstet Gynecol. 2017;49(3):322-329. doi:10.1002/uog.17388
Fuchs F, Monet B, Ducruet T, et al. Effect of maternal age on the risk of preterm birth: A large cohort study. PLoS One 2018; 13:e0191002.
How to Cite
Șucu Roxana and I. Bordeianu, “The Cervical Length Variation During Pregnancy at Patients with Previous Cesarean Scar”, JSS, vol. 8, no. 1, May 2021.