Preventing premature birth after a caesarean section

Our researchers want to find out whether a simple ultrasound screening test can be used to work out which women and birthing people who’ve had a caesarean section late in labour need extra monitoring and support in their next pregnancy.
  • Researchers

    Professor Anna David, Professor Andrew Shennan, Professor Kypros Nicolaides

    Start date: September 2023

Why do we need this research?

Women and birthing people who have a caesarean section late in labour, when their cervix is nearly fully dilated, are more likely to go into labour prematurely in their next pregnancy. This can happen because the caesarean section scar weakens the cervix, causing it to soften, shorten and open too early. The most common treatment for a short cervix is a cervical cerclage, where a stitch is placed around the neck of the womb to keep it closed. However, not all women and birthing people who have had a caesarean section late in labour need a cervical cerclage. 

What are the aims of this project?

Our researchers found that when the caesarean section scar is low down – within or close to the top of the cervix – it increases the chance of the cervix shortening and the baby being delivered too soon. As a result, they have developed a simple ultrasound technique that can measure the position of the caesarean section scar during the fetal anomaly scan, which takes place at around 20 weeks. The team now want to train clinicians from around the UK to accurately measure the caesarean section scar during pregnancy. They also want to confirm in a larger group of women and birthing people that a low caesarean section scar is linked to having a short cervix and premature birth. Finally, our researchers want to develop an ultrasound screening test – for use after birth – that could identify which people need extra cervical monitoring during their next pregnancy.

What difference will this project make?

We believe that this project will reduce the number of women and birthing people giving birth prematurely after having a caesarean section late in labour. It will also help make sure that women and birthing people with no damage to the cervix no longer receive unnecessary treatment.