scholarly journals OP08.02: Predictive value of cervical length by transvaginal sonography at 20–24 weeks to preterm delivery in twin pregnancy

2019 ◽  
Vol 54 (S1) ◽  
pp. 108-108
Author(s):  
X. Zhang ◽  
C. Shi
Author(s):  
Bijay Sur ◽  
Sujata Misra ◽  
Sanghamitra Dash

Background: This prospective observational study was conducted to evaluate the anterior cervical angle (ACA) of the uterus by transvaginal sonography (TVS) and to determine the feasibility to predict spontaneous preterm birth (PTB). The duration of the study was from December 2014-December 2016.The participants included 100 pregnant women with singleton pregnancy who were asymptomatic. They were enrolled after excluding all known risk factors of preterm birth.Methods: The ACA and cervical length were measured in all cases by transvaginal sonography either in the 1st trimester or 2nd trimester. All cases were followed and well documented with respect to the gestational age at delivery.Results: There was a significant risk of preterm labour in women with cervical length <2.5cm in the 2nd trimester with Odds Ratio 3.625, P value=0.001, sensitivity 75% and specificity 79.31%. The positive predictive value was 33.33% and negative predictive value 95.83%. The false positive rate was 20.65% and false negative rate 25%. The difference of mean cervical angle in women who delivered preterm and that of those who delivered at term, in the 1st    trimester (preterm group 114.2°Vs term group 93.0°, P<0.001) and in the 2nd trimester (preterm group 127.66° Vs term group 103.65°, P <0.001) was significant. An ACA of 114.2° in the 1st trimester was associated with a risk of spontaneous preterm birth (P value 0.0065, sensitivity 90% and specificity 80%). An ACA of 127.66° in 2nd trimester was associated with a risk of spontaneous preterm birth (P value 0.0004, sensitivity 80%and specificity 88.23%).Conclusions: Despite the limitations of a small sample size, the results suggest that the anterior cervical angle has potential as a new predictor of spontaneous preterm birth especially when measured in the 1st trimester.


2002 ◽  
Vol 12 (1) ◽  
pp. 46-49 ◽  
Author(s):  
S. H. Poggi ◽  
A. Ghidini ◽  
H. J. Landy ◽  
M. Alvarez ◽  
J. C. Pezzullo ◽  
...  

Author(s):  
Sandeep Sethumadhavan P. ◽  
Raju Agarwal ◽  
Jayamol M. Anilkumar ◽  
Anup Ramchandran Pillai

Background: Preterm birth is the leading cause of perinatal morbidity and mortality. Transvaginal sonographic measurement of the cervix is a reliable alternative method for the assessment of cervical length as it allows better quality and more accurate visualization of the uterine cervix. Several studies have reported that cervical assessment on transvaginal sonography may be useful in the prediction of preterm delivery. The objective of this study was to assess cervical length at 20 to 24 weeks of gestation in low risk women and correlate with the gestational age at delivery.Methods: A prospective cohort study conducted in a tertiary care Military Hospital in Pune, India. 354 asymptomatic low risk antenatal women with gestational age of 20 to 24 weeks were studied. Cervical assessment with transvaginal sonography for the measurement of cervical length was performed using a 10 MHz transvaginal probe.Results: 7 percent women delivered preterm. The incidence of short cervix in low risk women was only 0.56%. 100% women with short cervix delivered preterm and, only 6.9% patients who had cervical length more than 25 mm delivered preterm. Cervical length 25 mm has got sensitivity and NPV of 100% and a specificity of 93.46%. However, the PPV was only 8%.Conclusions: The study reported significant inverse relation between short cervix and the occurrence of preterm delivery. Our findings suggest that cervical length can be used as a screening method for preterm labour in low risk women. However strong evidences from large randomized control trials would be required to assess its cost-effectiveness. 


2021 ◽  
pp. 875647932110126
Author(s):  
Anna Fitzpatrick ◽  
Dora DiGiacinto

Objective: A short cervix during pregnancy indicates a higher risk of preterm delivery. Transvaginal sonography is widely used for the detection of a short cervix. The literature indicates that 21–24 weeks is the most sensitive gestational age to assess transvaginal cervical length (TV CL) of ≤2.5 cm for potential preterm delivery. Pregnancies between 18 and 20 weeks’ gestation are generally performed transabdominally; thus, it could be beneficial to have a recognized correlation between the transabdominal cervical length (TA CL) measurement and the TV CL measurement at this earlier time period. Materials and Methods: An online database search produced 13 research articles to be reviewed. Inclusion criteria consisted of TA CL and TV CL assessment of singleton pregnancies with intact membranes. Results: Findings indicate high diagnostic yield when a TA CL of <2.9 cm or TV CL of <2.5 cm is used for defining a shortened cervix when measured between 18 and 20 weeks’ gestation. Conclusion: This review of the literature indicates a correlation between average TA CL and average TV CL measurements, although the relationship widens as CLs become shorter.


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