scholarly journals Cervical length measurement by transvaginal sonography in predicting preterm labour in low risk women

2017 ◽  
Vol 6 (12) ◽  
pp. 5563
Author(s):  
Sandeep Sethumadhavan P. ◽  
Raju Agarwal ◽  
Jayamol M. Anilkumar ◽  
Anup Ramchandran Pillai
Keyword(s):  
Preterm Delivery ◽  
Gestational Age ◽  
Preterm Labour ◽  
Screening Method ◽  
Cervical Length ◽  
Low Risk ◽  
Military Hospital ◽  
Transvaginal Sonography ◽  
Short Cervix ◽  
Low Risk Women

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. 

scholarly journals COMPARISON OF THE PREDICTIVE VALUE OF TRANSVAGINAL CERVICAL LENGTH AT 11-14 WEEKS AND AT 20-22 WEEKS OF GESTATION IN PRETERM LABOUR

2020 ◽  
pp. 41-43
Author(s):  
Sudha Rani Mangalampeta
Keyword(s):  
Preterm Birth ◽  
Preterm Delivery ◽  
Gestational Age ◽  
Predictive Value ◽  
Preterm Labour ◽  
Statistical Significance ◽  
Cervical Length ◽  
Low Risk ◽  
Singleton Pregnancy ◽  
Low Risk Women

Background: Preterm labour is defined as the onset of labour before 37 weeks of gestation, in pregnancy beyond 20 weeks of gestation, and is responsible for nearly 75% of all neonatal mortality and neurological morbidity. Cervical length (CL) is one of the major determinants of preterm delivery. Several studies have been able to conclude that transvaginal CL assessment may be a useful tool for the prediction of preterm delivery. The risk of preterm birth varies inversely with CL measured by ultrasound in low-risk women. Objective: To evaluate and compare the predictive value of transvaginal cervical length between 11-14 weeks and 20- 22 weeks of gestation in preterm labour. Material and Methods: A total of 264 pregnant women who were primigravida, singleton pregnancy, and women at gestational age 11-14 weeks and 20-22 weeks were included in the study. They were subjected for CL measurement at 11-14 and 20-22 weeks of gestation using transvaginal ultrasonography with the standard longitudinal view of the cervix while the patient’s bladder was empty. GEL VOLUSON 730 PRO Trans Vaginal Ultrasound (TVS) probe IC 5-9 H instrument with 5-9 MHz was used to measure CL. Results: The variables analyzed were the mean cervical length at 11-14 weeks and 20-22 weeks, the rate of shortening of cervical length in those who deliver at term and preterm and the cervical length at 11-14 weeks 20-22 weeks was correlated with gestational age at delivery and the predictive value of the same was determined. Cut-off of cervical length at 11-14 and 20-22 weeks of gestation was 3.73 cm and 2.89 and was statistically significant for the prediction of pre-term labour. Reduction in cervical length from 11-14 weeks to 20-22 weeks of gestation of more than 0.7 cm is predictive of preterm labour with statistical significance (p<0.001). Conclusion: Routine mid-pregnancy cervical length assessment in low-risk women can be a cost-effective method of preterm birth reduction but the implementation of such a policy is highly dependent upon local factors. If it is to be undertaken, cervical length assessment should be performed according to a standardized technique.

Comparison of Transabdominal and Transvaginal Sonograms in Evaluation of Cervical Length During Pregnancy

2021 ◽  
pp. 875647932110126
Author(s):  
Anna Fitzpatrick ◽  
Dora DiGiacinto
Keyword(s):  
Preterm Delivery ◽  
Diagnostic Yield ◽  
Cervical Length ◽  
Transvaginal Sonography ◽  
Review Of The Literature ◽  
Inclusion Criteria ◽  
Short Cervix ◽  
Time Period ◽  
The Relationship ◽  
Singleton Pregnancies

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.

scholarly journals Transvaginal Sonographic Evaluation of the Cervix in Asymptomatic Singleton Pregnancy and Management Options in Short Cervix

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Resul Arisoy ◽  
Murat Yayla
Keyword(s):  
Preterm Delivery ◽  
Cervical Length ◽  
Transvaginal Sonography ◽  
Singleton Pregnancy ◽  
Management Options ◽  
Short Cervix ◽  
Cervical Gland ◽  
Prophylactic Cerclage ◽  
Singleton Pregnancies

Preterm delivery (PTD), defined as birth before 37 completed weeks of gestation, is the leading cause of perinatal morbidity and mortality. Evaluation of the cervical morphology and biometry with transvaginal ultrasonography at 16–24 weeks of gestation is a useful tool to predict the risk of preterm birth in low- and high-risk singleton pregnancies. For instance, a sonographic cervical length (CL) > 30 mm and present cervical gland area have a 96-97% negative predictive value for preterm delivery at <37 weeks. Available evidence supports the use of progesterone to women with cervical length ≤25 mm, irrespective of other risk factors. In women with prior spontaneous PTD with asymptomatic cervical shortening (CL ≤ 25 mm), prophylactic cerclage procedure must be performed and weekly to every two weeks follow-up is essential. This article reviews the evidence in support of the clinical introduction of transvaginal sonography for both the prediction and management of spontaneous preterm labour.

Cervical Cerclage versus Vaginal Progesterone for Management of Short Cervix in Low-Risk Women

2018 ◽  
Vol 36 (02) ◽  
pp. 111-117 ◽  
Author(s):  
Sarah Dotters-Katz ◽  
Brenna Hughes ◽  
Amber Wood
Keyword(s):  
Preterm Birth ◽  
Transvaginal Ultrasound ◽  
Cervical Length ◽  
Low Risk ◽  
Prior History ◽  
Short Cervix ◽  
Vaginal Progesterone ◽  
History Of ◽  
Secondary Outcomes ◽  
Low Risk Women

Objective To evaluate the risk of preterm birth in low-risk women with cervical length (CL) ≤25 mm on transvaginal ultrasound (TVUS) managed with vaginal progesterone (VagP) therapy versus cerclage. Study Design This is a retrospective cohort of women with no prior history of preterm birth or cervical insufficiency and CL ≤ 25 mm on TVUS, managed with either VagP therapy alone or cerclage (with or without VagP). The primary outcome was rate of preterm delivery < 37 weeks gestational age (GA). Secondary outcomes included delivery at ≤ 32 or ≤ 28 weeks GA, premature preterm rupture of membranes, pregnancy latency, GA at delivery, and composite neonatal outcome. Results Women undergoing cerclage placement (n = 31) were older and had an earlier GA at the time of diagnosis of short cervix compared with women receiving VagP (n = 62). Delivery at < 37 weeks occurred in 21/62 (33.9%) in the VagP group and 14/31 (45.2%) in the cerclage group (adjusted odds ratio: 1.72, 95% confidence interval: 0.52, 5.66). There were no differences in secondary outcomes. Conclusion Cerclage compared with VagP therapy did not decrease risk of preterm birth in women with CL ≤ 25 mm. Further research is needed to determine optimal management in such women given a residual 40% risk of preterm birth despite optimal therapy.

scholarly journals Use of cervical length, measured by transvaginal sonography at 22 to 26 weeks, as a predictor of preterm labour in twin pregnancy

2018 ◽  
Vol 7 (9) ◽  
pp. 3590
Author(s):  
Ricky Saini ◽  
Reena Yadav ◽  
B. Pathak
Keyword(s):  
Twin Pregnancy ◽  
Prospective Observational Study ◽  
Preterm Labour ◽  
Tertiary Care ◽  
Cervical Length ◽  
Transvaginal Sonography ◽  
Perinatal Morbidity ◽  
Short Cervix ◽  
Time Of Presentation

Background: Preterm labour and delivery contributes significantly to perinatal morbidity and mortality in twin gestation. Measurement of cervical length during antenatal period and subsequent follow up may identify women at risk for preterm labour.  The purpose of this study was to determine if measurement of cervical length at 22 to 26 weeks can be used as a predictor of preterm labour in twin pregnancy.Methods: This prospective observational study was carried out in 50 women with twin gestation in a tertiary care teaching hospital. Cervical length was measured using transvaginal sonography and repeated every four weeks till delivery. Cervical length of ≤30 mm was taken as short cervix and delivery before 37 weeks was taken as preterm delivery.Results: Total of 18 out of 50 women (36%) delivered between 32 to 34 weeks, 14 out of 50 (28%) delivered between 34 to 37 weeks, 7 out of 50 (14%) delivered at less than 32 weeks. Therefore, total preterm deliveries at less than 37 weeks were 78%. Total 11 out of 50 (22%) delivered at term i.e. at more than 37weeks. In women, who had short cervical length (≤ 30 mm) at the time of presentation, 14 out of 37 (38 %) delivered between 30 to 34 weeks, 12 out of 37 (32 %) women delivered between 34 to 37 weeks, 5 out of 37 (14%) delivered at ≤ 30 weeks. Rest 6 out of 37 (16 %) delivered after 37 weeks.Conclusions: Short cervical length of ≤30 mm on transvaginal sonography at 22-26 weeks of gestation in twin pregnancy may be used as a screening tool in prediction of preterm labour in asymptomatic twin pregnancy.

scholarly journals A prospective study of prediction of preterm delivery by cervical assessment by transvaginal sonography

2021 ◽  
Vol 8 (4) ◽  
pp. 531-534
Author(s):  
Garima Bagga Arora ◽  
Asmita Bodade ◽  
Ritesh Bodade ◽  
Lohit S Vaishnao ◽  
Gourav Bagga
Keyword(s):  
Preterm Birth ◽  
Preterm Delivery ◽  
Preterm Labour ◽  
Tertiary Care ◽  
Specific Treatment ◽  
Cervical Length ◽  
Human Potential ◽  
Transvaginal Sonography ◽  
Neonatal Deaths ◽  
A Prospective Study

Preterm birth is a major cause of death and a significant cause of long-term loss of human potential amongst survivors all around the world. Complications of preterm birth are the single largest direct cause of neonatal deaths, responsible for 35% of the world’s 3.1 million deaths a year, and the second most common cause of under-5 deaths after pneumonia. In this study, an attempt has been made to evaluate the usefulness of cervical assessment by TVS in prediction of risk of preterm delivery in low risk pregnant women, thereby earlier management option can be planned and patients specific treatment can be given at the earliest. The present study was carried out in tertiary care teaching hospital for 1 year from 1 Jan 2019 to 31 Dec 2019. Total of 100 study participants who underwent TVS assessments of cervix regularly followed up who underwent TVS assessment of cervix and were regularly follow up and delivered. The mean cervical length in all these women was 30±6.68 mm. It was observed that 51.72% of patients with short cervical length less than 25 mm had preterm labour compared to the patients with cervical length more than 25mm i.e. 4.22%. Cervical assessment by TVS is effective in predicting preterm labour.

scholarly journals A soft cervix, categorized by shear-wave elastography, in women with short or with normal cervical length at 18–24 weeks is associated with a higher prevalence of spontaneous preterm delivery

2018 ◽  
Vol 46 (5) ◽  
pp. 489-501 ◽  
Author(s):  
Edgar Hernandez-Andrade ◽  
Eli Maymon ◽  
Suchaya Luewan ◽  
Gaurav Bhatti ◽  
Mohammad Mehrmohammadi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Delivery ◽  
Shear Wave ◽  
Wave Speed ◽  
Shear Wave Elastography ◽  
Cervical Length ◽  
Singleton Pregnancy ◽  
Short Cervix ◽  
Shear Wave Speed ◽  
Spontaneous Preterm Delivery

AbstractObjective:To determine whether a soft cervix identified by shear-wave elastography between 18 and 24 weeks of gestation is associated with increased frequency of spontaneous preterm delivery (sPTD).Materials and methods:This prospective cohort study included 628 consecutive women with a singleton pregnancy. Cervical length (mm) and softness [shear-wave speed: (SWS) meters per second (m/s)] of the internal cervical os were measured at 18–24 weeks of gestation. Frequency of sPTD <37 (sPTD<37) and <34 (sPTD<34) weeks of gestation was compared among women with and without a short (≤25 mm) and/or a soft cervix (SWS <25thpercentile).Results:There were 31/628 (4.9%) sPTD<37 and 12/628 (1.9%) sPTD<34 deliveries. The combination of a soft and a short cervix increased the risk of sPTD<37 by 18-fold [relative risk (RR) 18.0 (95% confidence interval [CI], 7.7–43.9); P<0.0001] and the risk of sPTD<34 by 120-fold [RR 120.0 (95% CI 12.3–1009.9); P<0.0001] compared to women with normal cervical length. A soft-only cervix increased the risk of sPTD<37 by 4.5-fold [RR 4.5 (95% CI 2.1–9.8); P=0.0002] and of sPTD<34 by 21-fold [RR 21.0 (95% CI 2.6–169.3); P=0.0003] compared to a non-soft cervix.Conclusions:A soft cervix at 18–24 weeks of gestation increases the risk of sPTD <37 and <34 weeks of gestation independently of cervical length.

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