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Vaginal pH versus cervical length in the mid-trimester as screening predictors of preterm labor in a low-risk population

Objective was to assess diagnostic accuracy of vaginal pH and cervical length (CL) measurement in mid trimester regarding the prediction of preterm labor (PTL). Prospective cohort study of 316 low-risk pregnant women. The cut off value for vaginal pH was 5.0 (95th percentile) whereas for shortened CL was length < 26 mm (5th percentile). Elevated vaginal pH was found in 4.4% whereas shortened CL was found in 2.8%. The incidence of PTL (< 37 weeks) was 7.2%, and early PTL (< 34 weeks) was 3.4%. Shortened CL is significantly related to PTL (LR weighted by prevalence 2.7, 95% CI 1.1–6.7) but is not to early PTL (LR weighted by prevalence 0.8, 95% CI 0.4–1.8). Elevated vaginal pH is better predictor of PTL (LR weighted by prevalence 3.7, 95% CI 1.3– 10.4) and early PTL (LR weighted by prevalence 1.7, 95% CI 1.1– 3.1). Elevated vaginal pH has better accuracy in comparison with shortened CL regarding the prediction of early PTL in low risk pregnant women.

bacterial vaginosis; cervical incompetence; cervical length; preterm delivery; vaginal pH

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