A comparison of ultrasonic measurement techniques for the maternal cervix in the second trimester

O'Hara, Sandra; Zelesco, Marilyn; Sun, Zhonghua

doi:10.1002/j.2205-0140.2015.tb00211.x

Cited by 6 publications

(8 citation statements)

References 17 publications

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“…The average difference of .2 mm between cervical length measurements using TVUS and TPUS was negligible. However, in most cases TPUS underestimated cervical length, a finding that is similar to those of previous published studies . The TPUS cervical length measurement was reproducible with high intraobserver and interobserver correlation.…”

Section: Discussionsupporting

confidence: 89%

“…Previous studies have demonstrated that TPUS measurements correlate well with those obtained with TVUS (Table ). However, it is difficult to compare our results to those previously reported due to differences in methodology, gestational ages of women, patient position during measurement, and operator's experience.…”

Section: Discussionmentioning

confidence: 53%

“…Statistical analysis was performed using Stata Statistical Software: Release 10 (StataCorp LP, College Station, TX). The sample size was calculated based on O'Hara et al reported Pearson's correlation coefficient of .8. Using power of .80 and failure rate of 15%, resulted in a calculated sample size of 96.…”

Section: Methodsmentioning

confidence: 99%

“…Transabdominal US of the cervix may not produce clear images of the cervix and result in erroneous measurements . Many studies have demonstrated the correlation between TPUS and TVUS measurements of cervical length throughout all trimesters . In addition, pregnant women tend to prefer TPUS measurements .…”

Section: Introductionmentioning

confidence: 99%

“…In addition, pregnant women tend to prefer TPUS measurements . Failure to obtain a clear image of the cervix using TPUS has been reported in 0‐30% of cases, mainly due to shadowing caused by bowel gas or the pubic symphysis. In such cases, elevation of the patient hips can improve the image quality .…”

Section: Introductionmentioning

confidence: 99%

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Transperineal versus transvaginal sonographic measurements of cervical length in pregnant women between 16 and 24 weeks of gestation

Songserm

Komwilaisak

Saksiriwuttho

et al. 2019

J of Clinical Ultrasound

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Purpose To investigate the correlation between cervical length measurements using transvaginal and transperineal approaches at 16‐24 weeks of gestation. Methods The prospective study recruited 110 singleton pregnant women. All the measurements were performed by one operator who was blinded to the results of both approaches. Cervical length was first measured by transvaginal sonography (TVUS) then transperineal sonography (TPUS). The transvaginal approach was used as the reference measurement. Patient preference regarding the sonographic approaches was evaluated using questionnaire. Results Cervical length was successfully measured by TVUS in all cases. TPUS was successful in 108/110 participants. There was high correlation between the results of TVUS and TPUS (Pearson's correlation coefficient was .94; 95% CI .9 to .95. Lin's concordance correlation coefficient was .94; 95% CI .92‐.96). The estimated difference in cervical length measured using TVUS and TPUS was .2 mm. The 95% tolerance interval for paired observation was −1.8 to 2.3 mm. The interobserver coefficient of TPUS measurement was .98 (95% CI .92‐.99). TPUS was rated as resulting in mild or no discomfort and was preferred by most women. Conclusion TVUS and TPUS techniques showed high correlation in cervical length measurement with high interobserver reliability. More patients preferred TPUS. TPUS should be considered as an alternative method of cervical length measurement.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 53%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Transperineal versus transvaginal sonographic measurements of cervical length in pregnant women between 16 and 24 weeks of gestation

Songserm

Komwilaisak

Saksiriwuttho

et al. 2019

J of Clinical Ultrasound

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Shear wave elastography of the maternal cervix: A transabdominal technique

O'Hara

Zelesco

Sun

2018

Australas J Ultrason Med

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1Objectives This research aimed to identify biological and technical confounders in the non-2 pregnant cervix when applying shear wave elastography with an endovaginal transducer.3 Methods Cervical speed measurements were obtained at the internal and external os, anterior 4 and posterior portions of the cervix using a transvaginal approach in 69 non-gravid patients. 5Results Reliable measurements were obtained at the external os and internal os, anteriorly 6 and posteriorly, in 63, 55, 55 and 26 patients respectively. The mean speed obtained at the 7 external os, anteriorly and posteriorly, was 2.52 ± 0.49m/s and 2.87 ± 0.63m/s respectively, 8 and at the internal os anteriorly and posteriorly, 3.29 ± 0.79m/s and 4.10 ± 1.11m/s 9 respectively. The difference in speed between all regions was statistically significant 10 (p<0.05). 11 Conclusion Ultrasound -induced artifacts appear to affect the transmission of the 12 elastographic main pulse, with cervical position contributing to suboptimal shear wave 13 production in the posterior cervix. Reliable shear wave propagation can be achieved in the 14 anterior cervix in most patients. 15 16Retention of a pregnancy requires the cervix to maintain strength to withstand multiple forces 22 from the uterus, from the weight of the growing fetus and amniotic sac, and also passive 23 pressure from the uterine wall. The cervix softens and shortens throughout pregnancy and 24 finally dilates for the fetus to be delivered vaginally. Premature softening of the cervix is 25 associated with early shortening of cervical length and subsequent spontaneous preterm birth 26 (SPTB). 1 The cervix can be described as soft, firm or medium based on a digital 27 examination, but this method is subjective to the clinician, and creates difficulties due to the 28 expectation that the cervix will soften initially at the proximal portion. 1 29Currently, the length of the cervix assessed with transvaginal ultrasound (TVU) is the feature 30 that is assessed to indicate cervical strength and premature softening. 2 A short cervix has 31 been shown to be a significant risk factor for subsequent SPTB. 3 In women with a high risk 32 of SPTB due to medical history, a shortened cervical length on TVU has a sensitivity of over 33 50% for subsequent SPTB. However, in low risk women the sensitivity is reduced to 37%, 4,5 34 and the appropriate method for screening for SPTB in these women is yet to be established. 35With preterm birth affecting 13 million babies every year and the implications for neonatal 36 mortality and morbity, 6 there is a need for a non-invasive technique to assess cervical 37 strength with greater sensitivity than length alone. 38Ultrasound elastography assesses mechanical properties of tissues in the region being 39 examined. The basis for this technique is that soft tissue deforms differently from firm tissue 40 and the elastographic images reflect this difference. 7 Utilizing strain elastography, it has 41 been proposed it may be possible to identify women in the historically low r...

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