The Correlation of Ultrasonographic Cervical Length at Term to the Mode of Delivery: A Systematic Review and Meta-Analysis

This study was a systematic review and meta-analysis of observational studies published between 2015 and 2024 that used transvaginal ultrasonography cervical length measurements at term to predict the method of delivery. The review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. QUADAS (Quality Assessment of Diagnostic Accuracy Studies) was also used to assess the risk of bias and the quality of the included studies. The assessment criteria and results were reported and justified in a summary table. The studies showed significant heterogeneity (I2 = 98%, Q = 235.27). There was also inadequate statistical evidence to reject the null hypothesis that cervical lengths had no effect on mode of delivery (p = 0.10). The ROC analysis revealed relatively modest predictive accuracy (AUC = 0.722) with no statistically significant relationship (p = 0.151). In conclusion, it was found that ultrasonographic cervical length at term should not be used to make delivery decisions on its own. Additionally, there is still a need to assess numerous clinical aspects and argue for additional research to develop better predictive models.

Keywords: Caesarean Section, Mode of Delivery, Predictive Value, Spontaneous Vaginal Delivery, Ultrasonographic Cervical Length.