Transvaginal ultrasound measurement of cervical length and efficacy of misoprostol in first-trimester pregnancy failure

Objective The aim of this study was to assess the role of cervical length measurement in predicting successful treatment, by misoprostol administration, of early (first-trimester) pregnancy failure. Method A prospective study was conducted of all patients who agreed to medical treatment of pregnancy failure. Cervical length and other sonographic variables were measured using pelvic ultrasound before medical treatment began. Measurements were compared between the group with successful medical treatment and the group in whom treatment failed. Results In 125 women included in the study, the success rate of misoprostol treatment was 64.8%. There were no significant differences between the groups with successful and failed treatment for cervical length (29.9 ± 9.3 vs. 30.4 ± 6.8 mm, P = 0.75), distance between gestational sac and ‘virtual’ cervical internal os (23.9 ± 13 vs. 26.6 ± 13 mm, P = 0.26), crown–rump length (8.7 ± 9.7 vs. 6.7 ± 8.6 mm, P = 0.25), or gestational sac diameter (31.3 ± 14 vs. 30.1 ± 15 mm, P = 0.73). Conclusion Cervical length does not predict the success of misoprostol treatment of first-trimester pregnancy failure. Copyright © 2007 ISUOG. Published by John Wiley & Sons, Ltd.