Cervical Length Measurement as a Predictor of Preterm Birth in High-Risk Pregnancies at University of Abuja Teaching Hospital

Transvaginal cervical length measurement is a validated predictor of preterm birth risk, enabling targeted interventions including progesterone therapy and cervical cerclage, yet its systematic clinical application in Nigerian high-risk pregnancy units requires empirical evaluation. This prospective observational study evaluates the predictive value of transvaginal cervical length measurement for preterm birth in high-risk pregnancies at the University of Abuja Teaching Hospital (UATH), Gwagwalada, FCT. One hundred and twenty women with high-risk indications including prior preterm birth, multiple gestation, uterine anomaly, and cervical surgery underwent transvaginal cervical length measurement at 18 to 24 weeks and again at 24 to 28 weeks. Delivery before 37 weeks was the primary outcome. Receiver operating characteristic (ROC) curve analysis determined optimal cervical length cut-offs. Cervical length below 25 mm at 20 to 24 weeks predicted preterm birth with sensitivity of 78 percent, specificity of 71 percent, and AUC of 0.82. Cervical length below 20 mm at 24 to 28 weeks had higher predictive accuracy (AUC 0.88). Progesterone therapy initiated after short cervical length detection was associated with a 42 percent relative reduction in preterm birth. Prior preterm birth combined with short cervical length was the highest-risk combination. The study validates transvaginal cervical length as a useful preterm birth predictor in UATH high-risk pregnancies and recommends its standardisation in the antenatal high-risk clinic. Keywords: cervical length, preterm birth prediction, high-risk pregnancy, UATH, transvaginal ultrasound