Cervical gland area as an ultrasound marker for prediction of preterm delivery: A cohort study

Abstract

Background:Preterm labor is a major cause of perinatal morbidity and mortality and it might be predicted by assessing the cervical change.Objective: To assess the association between absence of cervical gland area (CGA) and spontaneous preterm labor (SPTL).Materials and Methods: This prospective cohort study was performed on 200 singleton pregnant women with a history of SPTL, second-trimester abortion in the previous pregnancy or lower abdominal pain in current pregnancy. Each patient underwent one transvaginal ultrasound examination between 14-28 wk of gestation. Cervical length was measured and CGA was identified and their relationship with SPTL before 35 and 37 wk gestation was evaluated using STATA software version 10.Results:The mean of cervical length was 36.5 mm (SD=8.4), the shortest measurement was 9 mm, and the longest one was 61 mm. Short cervical length (≤18mm) was significantly associated with SPTL before 35 and 37 wk gestation.Cervical gland area (the hypoechogenic or echogenic area around the cervical canal) was present in 189 (94.5%) patients. Absent of CGA had a significant relationship with SPTL before 35 and 37 wk gestation (p=0.01 and p<0.001, respectively). Cervical length was shorter in women with absent CGA in comparison with subjects with present CGA: 37±10 mm in CGA present group and 23±9 mm in CGA absent group (p<0.001).Conclusion:Our study showed that cervical gland area might be an important predictor of SPTL which should be confirmed with further researches.

Cervical Assessment for Predicting Preterm Birth—Cervical Length and Beyond

“…This absence of glands may signify the beginning of the cervical ripening process [80][81][82]. In another study, 600 pregnant women were scanned at 16-19 weeks of gestation, and the CGA was detected in 77% of the women who delivered at term vs. 55% of those who did not [80].…”

“…The absence of normal mucosal glands (cervical gland area), which is demonstrated by a hyperechoic or hypoechoic segment around the cervical mucosa, has also been proposed as a predictor of a PTB [80]. In past studies, it was shown that the detection rate of the CGA decreased after 31 weeks of gestation [81].…”

Gestational age‐related changes in cervical gland length in normal singleton pregnancies from 17 to 36 weeks of gestation

“…In addition, the CGA disappears at the second trimester in cases of preterm delivery before 32 weeks of gestation 2 . Therefore, the absence of the CGA can be clinically useful as a sonographic marker for cervical maturation in normal pregnancy and the prediction of preterm delivery 2–8 . Previous studies have focused on the presence or absence of CGA during the progression of gestation.…”

“…2 Therefore, the absence of the CGA can be clinically useful as a sonographic marker for cervical maturation in normal pregnancy and the prediction of preterm delivery. [2][3][4][5][6][7][8] Previous studies have focused on the presence or absence of CGA during the progression of gestation. However, there are no studies concerning the quantitative evaluation of longitudinal changes in the CGA, such as the actual length of the sonographically described cervical gland.…”

Multidimensional screening for a multifunctional cervix: Examining cervical gland area at cervical length screening to predict spontaneous preterm birth.

“…However, sonographic CL has variable sensitivity for screening, and its predictive value in the general obstetric population remains suboptimal 7,9,10 . The character of the cervical canal itself, specifically the cervical gland area (CGA), has been proposed as another useful reflection of cervical function [11][12][13] .…”