Background & Objective: Second-trimester pregnancy termination is a common procedure where predicting its duration remains a clinical challenge. Measuring Transvaginal Sonographic (TVS)
Cervical Length (CL) is a validated predictor for labor induction at term, its role in medical abortion is less defined. The present study was conducted with aim to evaluate the value of TVS CL measurement in predicting the induction-to-expulsion interval in second-trimester Termination Of Pregnancy (TOP) using misoprostol.Materials & Methods: This prospective study was conducted on ۴۵ women between ۱۳–۲۶ weeks of gestation undergoing second-trimester termination specifically for fetal demise (missed abortion). TVS CL was measured prior to induction. Patients received misoprostol per FIGO (۲۰۲۳) guidelines. The primary outcome was the correlation between CL and the induction-to-expulsion interval. Secondary outcomes included correlations with total misoprostol dose and parity. Data was analyzed using SPSS software. P<۰.۰۵ was considered statistically significant.Results: The mean cervical length (۳۱.۹۶ mm) was a significant determinant of the induction-to-expulsion interval (۲۱.۲۷ hours), demonstrating a moderate positive correlation (r=۰.۳۷۴, P=۰.۰۱۱). A near-linear relationship was observed between cervical length and the total misoprostol dose (r=۰.۹۷۲, P<۰.۰۰۰۱). Conversely, parity exhibited a moderate inverse correlation with expulsion time (r=-۰.۳۳۷, P=۰.۰۲۳).Conclusion: Transvaginal sonographic measurement of cervical length is a significant predictor of both the duration of second-trimester medical abortion and the required misoprostol dose. A longer cervix is associated with a prolonged abortion process and a higher medication requirement. Incorporating CL assessment into pre-procedure planning can enhance patient counseling and potentially guide individualized dosing protocols to improve the efficiency of medical abortion care.
