Significance of cervical length and cervical gland area in cervical maturation

Multidimensional screening for a multifunctional cervix: Examining cervical gland area at cervical length screening to predict spontaneous preterm birth.

“…One longitudinal study used serial TVUS and digital cervical exams to chart the natural course of CL, CGA, and Bishop score with advancing GA in low-risk patients delivered at term; they found increasing rates of CGA absence from 31 weeks to term, correlating with a rising cervical maturation index 13 . Conversely, persistent visibility of CGA at term has been associated with increased need for late-term labor induction and increased rates of failed induction 30,31 . Loss of a sonographically detectable CGA consistently correlates with cervical maturation, supporting the biologic plausibility of a connection between this ultrasound finding and increased PTB risk from premature cervical ripening.…”

“…The biologically active endocervical glands play a crucial role in the balance of collagen and other proteins that contribute to the biomechanical strength of the cervix, as well as the cervical mucous required to maintain a barrier between the vagina and an intrauterine gestation 15,17,32,33 . Sonographic CGA evaluation may lend itself to an improved functional appraisal of PTB risk as the loss of visualizable CGA coincides with underlying cervical ripening 13,19,[29][30][31] . This connection may be applicable across several disciplines of obstetrics and gynecology, such as for birth outcomes after infertility or oncologic care.…”