Limited Predictive Value of Uterocervical Angle Compared With Cervical Length for Preterm Birth in Symptomatic Pregnancies

Objective: Preterm birth (PB) remains one of the leading causes of neonatal morbidity and mortality. Accurate prediction and appropriate management may reduce adverse neonatal outcomes. The aim of this study was to evaluate the uterocervical angle (UCA) measurement, assessed by transvaginal ultrasonography, compared with cervical length (CL), for predicting PB in symptomatic pregnancies. Materials and Methods: This cohort study included 70 singleton pregnant women between 24 and 34 weeks of gestation who presented with uterine contractions. Demographic characteristics, Bishop score, CL, and UCA measurements were recorded. Gestational age at birth, mode of delivery, birth weight, sex, and neonatal intensive care unit admission were documented. Results: A measurement of CL ≤27 mm was significantly more frequent in the PB group compared with the term group (34.8% vs 10.6%, P = .022). At the optimal cut-off of ≤27 mm, CL showed a sensitivity of 34.8% and a specificity of 89.4%, with a positive predictive value (PPV) of 61.5% and a negative predictive value (NPV) of 73.7%. In contrast, the UCA did not differ significantly between the PB and term groups (median 93° vs 91°; P = .521) and did not predict PB. Conclusion: In this cohort, the UCA measurement was not a statistically significant predictor of PB, whereas CL measurement demonstrated significant predictive value for increased risk of preterm delivery.