Cervicovaginal Beta-hCG as a Diagnostic Biomarker for Prediction of Preterm Labor and its Co-relation with Cervical Length in Transvaginal Sonography
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Abstract
Background: To assess whether cervicovaginal β-human chorionic gonadotropin (β-HCG) and cervical length (CL) by transvaginal sonography predict spontaneous preterm delivery. Methods: In this prospective study, 150 singleton pregnancies at 24-34 weeks’ gestation were enrolled at GSVM Medical College, Kanpur. 67 women who delivered before 37 weeks formed the preterm group, and 83 delivered at/after term formed term group. Cervicovaginal fluid was assayed for β-HCG (chemiluminescent immunoassay). Cervical length was measured transvaginally. Statistical analysis included t-tests, chi-square tests, ROC curves, and multivariate logistic regression for determining predictive value of beta-hcg and its co-relation with cervical length. Results: Mean cervicovaginal β-HCG was higher in the preterm group (27.8 ± 14.4 mIU/mL vs. 9.5 ± 9.9 mIU/mL; p < 0.001). Mean CL was shorter (2.58 ± 0.27 cm vs. 2.90 ± 0.32 cm; p <0.001). Optimal β-HCG cutoff 10.2 mIU/mL yielded 88.1% sensitivity and 80.7% specificity (AUC= 0.845). CL cutoff ≤2.8 cm gave 82.1% sensitivity and 58.0% specificity (AUC = 0.774). Combined β-HCG and CL improved AUC to 0.936. On multivariate analysis, elevated β-HCG (adjusted OR 4.82, p < 0.001) and shortened CL (adjusted OR 0.38 per cm, p < 0.001) were independent predictors. Conclusion: Cervicovaginal β-HCG and TVS cervical length are effective, complementary predictors of preterm delivery. Their combined use enhances risk stratification and may guide early interventions.
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Copyright (c) 2025 Dr. Riddhima Tripathi, Dr. Divya Dwivedi, Dr. Neena Gupta, Dr. Shaily Agarwal, Dr. Pavika Lal
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons License All articles published in Annals of Medicine and Medical Sciences are licensed under a Creative Commons Attribution 4.0 International License.
Dr. Riddhima Tripathi, Junior Resident, Department of Obstetrics and Gynaecology, GSVM Medical College, Kanpur, India.
Junior Resident, Department of Obstetrics and Gynaecology, GSVM Medical College, Kanpur, India.
Dr. Divya Dwivedi, Associate Professor, Department of Obstetrics and Gynaecology, GSVM Medical College, Kanpur, India.
Associate Professor, Department of Obstetrics and Gynaecology, GSVM Medical College, Kanpur, India.
Dr. Neena Gupta, Professor, Department of Obstetrics and Gynaecology, GSVM Medical College, Kanpur, India.
Professor, Department of Obstetrics and Gynaecology, GSVM Medical College, Kanpur, India.
Dr. Shaily Agarwal, Professor, Department of Obstetrics and Gynaecology, GSVM Medical College, Kanpur, India.
Professor, Department of Obstetrics and Gynaecology, GSVM Medical College, Kanpur, India.
Dr. Pavika Lal, Associate Professor, Department of Obstetrics and Gynaecology, GSVM Medical College, Kanpur, India.
Associate Professor, Department of Obstetrics and Gynaecology, GSVM Medical College, Kanpur, India.
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