A prospective comparative study of transvaginal ultrasonography and digital examination for cervical assessment in the third trimester of pregnancy

Lim, Boon; Mahmood, T. A.; Smith, N. C.; Beat, Ian

doi:10.1002/jcu.1870200906

Cited by 13 publications

(7 citation statements)

References 12 publications

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“…It has been suggested that preterm labor can be predicted in twin pregnancies by serial digital examination (3). Transvaginal ultrasound correlates well with digital findings and has the advantage over digital examination, because it avoids the theoretical risk of prostaglandin release, allows for the whole length of the cervix to be measured and minimizes inter-observer error (4). Although transabdominal ultrasound can be used to visualize the cervix, transvaginal ultrasound is more accurate, reproducible and is better at predicting preterm delivery in singletons (5).…”

Section: Discussionmentioning

confidence: 99%

Cervical length assessment in twin pregnancies using transvaginal ultrasound

Ong¹,

Smith²,

Smith³

et al. 2000

Acta Obstet Gynecol Scand

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Section: Discussionmentioning

confidence: 99%

Cervical length assessment in twin pregnancies using transvaginal ultrasound

Ong¹,

Smith²,

Smith³

et al. 2000

Acta Obstet Gynecol Scand

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“…Furthermore, several studies have shown that ultrasonographic cervical assessment is more accurate than digital examination for identifying cervical changes (4,5).…”

Section: Introductionmentioning

confidence: 99%

Relation of cervical length at 22-24 weeks of gestation to demographic characteristics and obstetric history

Palma-Dias

Fonseca²,

Stein

et al. 2004

Braz J Med Biol Res

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Preterm delivery is the main cause of neonatal death and ultrasonographic cervical assessment has been shown to be more accurate than digital examination in recognizing a short cervix. This is a crosssectional study, involving 1131 women at 22-24 weeks of pregnancy, designed to determine the distribution of cervical length and to examine which variables of demographic characteristics and obstetric history increase the risk of a short cervix (15 mm or less). The distribution of maternal demographic and obstetric history characteristics among patients with cervical length ≤15 mm was analyzed and compared to the findings for the general population. Risk ratios (RR) between subgroups were generated from this comparison. Median cervical length was 37 mm and in 1.5% of cases it was 15 mm or less. The proportion of women with a short cervix (≤15 mm) was significantly higher among patients with a low body mass index (RR = 3.5) and in those with previous fetal losses between 16-23 weeks (RR = 33.1) or spontaneous preterm deliveries between 24-32 weeks (RR = 14.1). We suggest that transvaginal sonographic measurement of cervical length be performed as part of a routine midtrimester ultrasound evaluation. There are specific variables of demographic characteristics and obstetric history which increase the risk of detecting a short cervix at 22-24 weeks.

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“…However, the Bishop score is a subjective method of assessing the cervix and it has been reported to be of limited value in women with a low score, as a predictor of successful induction [8,9] . Transvaginal sonographic measurement of the cervical length has been reported recently as a method which can provide a more sensitive prediction of successful labor induction [10,11] . Although transvaginal ultrasonographic cervical measurement is easily reproducible and quantitative, several studies have demonstrated confl icting results [12][13][14][15] .…”

mentioning

confidence: 99%

Sonographic Cervical Length Measurement before Labor Induction in Term Nulliparous Women

et al. 2005

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Objective: The purpose of the study was to determine if transvaginal sonographic measurement of the cervical length is a useful method to predict successful labor induction in nulliparas. Methods: 137 women who were scheduled for medically indicated induction of labor had a transvaginal sonographic measurement of the cervical length before labor induction. Inclusion criteria were: (1) singleton pregnancy; (2) gestational age between 37–42 weeks; (3) live fetus in cephalic presentation; (4) intact membranes; (5) no vaginal bleeding; (6) no previous history of uterine surgery; (7) nulliparous women, and (8) no allergy or asthma in response to prostaglandins. Induction of labor was performed within 6 h of the ultrasonographic examination, by inserting 2 mg of dinoprostone in the posterior vaginal fornix, repeated if needed every 6 h for up to three doses. When the cervix became favorable and no regular contractions were observed, amniotomy and oxytocin augmentation, starting at 1 mIU/min and increasing 1 mIU every 30 min as necessary, was performed. Results: All women were Caucasians and the mean age was 24.3 years (range 19–37 years). The mean cervical length was 28 mm (range 11–39 mm). The Bishop score was ≤5 in 101 women and >5 in the 36 others. Vaginal delivery occurred in 92 women (67.1%), and the vast majority of them (89 women; 96.7%) gave birth within 24 h of induction. Forty-five women (32.8%) had a cesarean section. The Bishop score was not predictive of the mode of delivery. Thirty-six of 101 women (35.6%) with a Bishop score ≤5 delivered by cesarean section, compared to 9 of 36 women with a Bishop score >5 (25%) (p = NS). Women with a cervical length <27 mm were more likely to deliver vaginally. Using this cutoff value the sensitivity of a successful labor induction was 76% and the specificity was 75.5%. Conclusions: Transvaginal sonographic measurement of cervical length is a good predictor of a successful labor induction at term in nulliparas.

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A prospective comparative study of transvaginal ultrasonography and digital examination for cervical assessment in the third trimester of pregnancy

Cited by 13 publications

References 12 publications

Cervical length assessment in twin pregnancies using transvaginal ultrasound

Cervical length assessment in twin pregnancies using transvaginal ultrasound

Relation of cervical length at 22-24 weeks of gestation to demographic characteristics and obstetric history

Sonographic Cervical Length Measurement before Labor Induction in Term Nulliparous Women

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