Role of transvaginal ultrasound in predicting preterm labor in singleton pregnancies
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20180172Keywords:
Cervical, Delivery, Preterm, TransvaginalAbstract
Background: Preterm delivery (PTD) is a major cause of perinatal morbidity and mortality. Objective of present study was to identify the women at risk of preterm delivery with the help of trans-vaginal ultrasound by assessing cervical length changes, funneling of lower uterine segment, cervical dilatation.
Methods: A prospective study was carried out over a period of 2 years on 50 patients with 24-36 weeks of gestation who clinically presented with signs of threatened preterm labor and were subjected to transvaginal sonographic measurement of cervical length.
Results: Prediction of spontaneous preterm birth at <37 weeks of gestation with cervical length to be 2.75 cm has sensitivity of 95%, specificity of 96.5%, positive predictive value of 86.36% and negative predictive value of 98.7%.
Conclusions: Transvaginal ultrasonography is the reliable, reproducible and objective method to assess cervix and to predict the risk of preterm delivery.
References
Meis PJ, Goldenberg RL, Mercer BM, Iams JD, Moawad AH, Miodovnik M et al. The preterm prediction study: risk factors for indicated preterm births. Am J Obstet Gynecol. 1998;178(3):562-7.
Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet. 2008 Jan 11;371(9606):75-84.
Celik E, To M, Gajewska K, Smith GC, Nicolaides KH. Cervical length and obstetric history predict spontaneous preterm birth: development and validation of a model to provide individualized risk assessment. Ultrasound Obstet Gynecol. 2008 May 1;31(5):549-54.
Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Mathews TJ, Kirmeyer S et al. Births: final data for 2007. Natl Vital Stat Rep. 2010 Aug 9;58(24):1-85.
Martin JA, Osterman MJ, Sutton PD. Are preterm births on the decline in the United States? Recent data from the National Vital Statistics System. NCHS data brief. 2010 May;39:1-8.
Tongsong T, Kamprapanth P, Srisomboon J, Wanapirak C, Piyamongkol W, Sirichotiyakul S. Single transvaginal sonographic measurement of cervical length early in the third trimester as a predictor of preterm delivery. Obstet Gynecol. 1995 Aug 1;86(2):184-7.
Barber MA, Eguiluz I, Plasencia W, Medina M, Valle L, Garcia JA. Preterm delivery and ultrasound measurement of cervical length in Gran Canaria, Spain. Int J Gynecol Obstet. 2010 Jan;108(1):58-60.
Buchanan SL, Crowther CA, Levett KM, Middleton P, Morris J. Planned early birth versus expectant management for women with preterm prelabour rupture of membranes prior to 37 weeks' gestation for improving pregnancy outcome. Cochrane Database Syst Rev. 2010 Mar 17;(3):CD004735.
Stoll BJ, Hansen NI, Bell EF, Shankaran S, Laptook AR, Walsh MC et al. Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. Pediatrics. 2010 Sep 1;126(3):443-56.
Gopi Chandern V, Luke DM, Vinodhine R, Rao R, Savitha MS, Mohan MR et al. psycho-socio-economic stress a risk factor for preterm labor:a community based, case control study from rural south India. Wati Med J India. 2010;23:184-5.
Iams JD, Berghella V. Care for women with prior preterm birth. Am J Obstet Gynecol. 2010 Aug 31;203(2):89-100.
Raga F, Bauset C, Remohi J, Bonilla-Musoles F, Simón C, Pellicer A. Reproductive impact of congenital Müllerian anomalies. Hum Reprod (Oxford, England). 1997 Oct 1;12(10):2277-81.
Rackow BW, Arici A. Reproductive performance of women with müllerian anomalies. Curr Opinion Obstet Gynecol. 2007 Jun 1;19(3):229-37.
Donders GG, Riphagen I, Van den Bosch T. Abnormal vaginal flora, cervical length and preterm birth. Ultrasound Obstet Gynecol. 2000 Oct 1;16(5):496-7.
Donders GG, Van Calsteren K, Bellen G, Reybrouck R, Van den Bosch T, Riphagen I, Van Lierde S. Predictive value for preterm birth of abnormal vaginal flora, bacterial vaginosis and aerobic vaginitis during the first trimester of pregnancy. BJOG: Int J Obstet Gynaecol. 2009 Sep 1;116(10):1315-24.
Lamont RF, Taylor‐Robinson D. The role of bacterial vaginosis, aerobic vaginitis, abnormal vaginal flora and the risk of preterm birth. BJOG: Int J Obstet Gynaecol. 2010;117(1):119-20.
Peltier MR. Immunology of term and preterm labor. Reprod Biol Endocrinol. 2003 Dec 2;1(1):122.
Mauldin JG, Newman RB. Preterm birth risk assessment. InSeminars Perinatol. 2001;25(4):215-22.
Reichmann JP. Home uterine activity monitoring: the role of medical evidence. Obstet Gynecol. 2008 Aug 1;112(2, Part 1):325-7.
Murakawa H, Utumi T, Hasegawa I, Tanaka K, Fuzimori R. Evaluation of threatened preterm delivery by transvaginal ultrasonographic measurement of cervical length. Obstet Gynecol. 1993 Nov 1;82(5):829-32.
Budi H, Usuf. J, Effendi S. Prediction of risk for preterm delivery by ultrasonographic measurement of cervical length at Hassan sadikin hospital. Am J Res Commun. 2015;3(3):1-7.
Tsoi E, Akmal S, Rane S, Otigbah C, Nicolaides KH. Ultrasound assessment of cervical length in threatened preterm labor. Ultrasound Obstet Gynecol. 2003 Jun 1;21(6):552-5.
Ekaputri P, Bernolian N, Ansyori H, Azhari A, Husin S. Transvaginal ultrasound assessment of cervical length in threatened preterm labor. Indonesian J Obstet Gynecol. 2013 Jun 26;36(2):81-4.
Vafaei H, Khorami F, Heydari ST, Ghaffarpasand F. Predictive Value of Cervical Length Measurement by Transvaginal and Transperineal Ultrasonography for Preterm Delivery. Shiraz E-Med J. 2014 Sep;15(3):19352.
Bagga R, Takhtani M, Suri V, Adhikari K, Arora S, Bhardwaj S. Cervical length and cervicovaginal HCG for prediction of pre-term birth in women with signs and symptoms of pre-term labour. J Obstet Gynaecol. 2010 Jul;30(5):451-5.
Leung TN, Pang MW, Leung TY, Poon CF, Wong SM, Lau TK. Cervical length at 18–22 weeks of gestation for prediction of spontaneous preterm delivery in Hong Kong Chinese women. Ultrasound Obstet Gynecol. 2005 Dec;26(7):713-7.
