Cervical length measurement: Comparison of transabdominal and transvaginal approach

Westerway, Susan Campbell; Pedersen, Lars Henning; Hyett, Jon

doi:10.1002/j.2205-0140.2015.tb00019.x

Cited by 18 publications

(27 citation statements)

References 24 publications

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“…[39] In some studies, when measuring CL, transabdominal measurement does not reflect the transvaginal measurement accurately. [40,41] Thus, when assessing cervical stiffness, the cervix condition may be affected by the compression of bladder fullness. However, subgroup analysis showed no significant difference in transvaginal US and transabdominal US when assessing the elastography of the cervix ( P = .12).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of cervical elastography in predicting preterm delivery

et al. 2019

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Background: The aim of the study was to evaluate the diagnostic accuracy of cervical elastography in predicting preterm delivery (PTD). Methods: We searched the PubMed, EMBASE, and Cochrane databases to identify relevant studies that applied ultrasound (US) elastography to assess cervical stiffness and predict PTD. All the studies were published before December 11, 2018, and only studies published in English were collected. The cervical length (CL) was considered a comparator, and the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was applied to assess the quality of the included studies. Summary receiver operating characteristic (SROC) modeling was performed to evaluate the diagnostic performance of cervical elastography in predicting PTD. Subgroup analyses were also performed. Results: Seven studies, including 1488 pregnant women, were included in this meta-analysis. Cervical elastography showed a summary sensitivity of 0.84 [95% confidence interval (CI): 0.68, 0.93], a specificity of 0.82 (95% CI: 0.63, 0.93), a diagnostic odds ratio of 25 (95% CI: 7, 93), and an area under the curve (AUC) of SROC of 0.90 (95% CI: 0.87–0.93). CL measurement showed that the AUC of SROC was 0.60 (95% CI: 0.56–0.64). The results of subgroup analysis showed that the summary sensitivity and specificity were different in the QUADAS-2 score subgroups. Conclusion: Cervical elastography is a promising and reliable method to predict PTD. Cervical elastography showed better diagnostic performance to predict PTD than CL measurement.

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Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of cervical elastography in predicting preterm delivery

et al. 2019

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“…Cervical cerclage is an obstetric procedure first described in the 1950s, where a suture is placed around the cervix for prevention of preterm birth (PTB) [ 3 ]. PTB is defined as delivery prior to 37 weeks of gestations and can lead to increase morbidity and mortality [ 3 – 6 ]. The World Health Organisation defines PTB <28 weeks as extreme preterm, 28-32 weeks as very preterm, and 32-37 weeks as late preterm [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…The cervical length is most accurately measured using transvaginal ultrasound as it is more reproducible than transabdominal ultrasound [ 6 ]. The measurement will vary depending on the gestation, with shortening occurring as the pregnancy continues.…”

Section: Introductionmentioning

confidence: 99%

Emergency versus Elective Cervical Cerclage: An Audit of Our First Two Years of Service

Vasudeva

Reddington

Bogdanska

et al. 2018

BioMed Research International

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One of the biggest obstetric challenges is the diagnosis and management of a short cervix as cervical length has an inverse relationship with risk of preterm birth. A cervical cerclage is a surgical procedure to reduce the risk of preterm birth and can be placed in an elective or emergency setting. This is a retrospective review of cervical cerclages inserted at an outer metropolitan hospital from February 2014 to May 2017. Since the introduction of the service, a total of 43 patients were identified as requiring a cervical cerclage. Four of these patients were transferred to tertiary hospitals. Of the 39 cerclages inserted, 26 were elective and 13 were emergency, placed at a mean gestation of 15.6 and 19.6 weeks. In total, there were 35 live births, 2 stillbirths, and 2 neonatal deaths. The maternal demographics (age, gravidity, parity, and preterm risk factors) were not statistically significant between the two groups. The mean pregnancy prolongation and birthweight was greater in the elective than the emergency group (21.4 versus 14.1 weeks; 3148.2 versus 2447.2 grams). There was no obvious pattern with which patients received antibiotics pre-, intra-, or postoperatively or received a vaginal swab. This audit identified the need for improvements to guidelines to standardise the use of antibiotics and progesterone in women with a cervical cerclage.

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“…6 Close localisation of the probe to the structures being examined allows for the use of higher frequency transducers. 12 There is a paucity of data comparing transabdominal and transvaginal ultrasound approaches to assess placental site. In contrast, the transabdominal measurement often requires filling of the bladder to allow for clearer identification of the internal cervical os, but this can also distort the local anatomy and in turn increase the error in measurement.…”

Section: Introductionmentioning

confidence: 99%

“…Similar arguments have been made about the value of a transvaginal approach when measuring cervical length as a means of screening for spontaneous preterm labour. 12 There is a paucity of data comparing transabdominal and transvaginal ultrasound approaches to assess placental site. In this study, we aimed to compare transabdominal and transvaginal measurement of the distance from the leading placental edge to the internal cervical os, to assess intra-and interobserver variation of these measurements and to define the efficacy of transabdominal assessment in correctly diagnosing a low-lying placenta.…”

Section: Introductionmentioning

confidence: 99%

Measuring leading placental edge to internal cervical os: Transabdominal versus transvaginal approach

Westerway

Hyett

Pedersen

2017

Australas J Ultrason Med

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We aimed to compare the value of transabdominal (TA) and transvaginal (TV) approaches for assessing the risk of a low-lying placenta. This involved a comparison of TA and TV measurements between the leading placental edge and the internal cervical os. We also assessed the intra-/interobserver variation for these measurements and the efficacy of TA measures in screening for a low placenta. Methodology: Transabdominal and TV measurements of the leading placental edge to the internal cervical os were performed on 369 consecutive pregnancies of 16-41 weeks' gestation. The difference (TA-TV) from the mean was calculated and plotted against gestational age. Bland-Altman plots and paired t-tests were used to look at the differences in TA/TV measurement. Screening performance of a transabdominal approach was compared to a transvaginal 'gold standard'. Nonparametric methods were used to calculate the area under the receiver operator characteristics (ROC) curve. Intra-/interobserver variations were also calculated. Results: Of the pregnancies, 278 had a leading placental edge that was visible with the TV approach. Differences (TA-TV) ranged from À50 mm to +57 mm. Bland-Altman plot shows that TA measurements overestimated the distance compared with the TV measurements; the average difference in measurement was 12.0 mm (95% confidence interval 9.9-14.1). The sensitivity, specificity and negative predictive values of a TA approach were 18.2%, 97.5% and 87.2%, respectively. The receiver operator characteristics area between gestational weeks 16-23 was 0.81 (95% CI: 0.76-0.86). Conclusion: The TA approach has a low sensitivity for detecting a low-lying placenta as choosing a TA cut-off with sensitivity >90% will decrease the specificity to 50%.

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Cervical length measurement: Comparison of transabdominal and transvaginal approach

Cited by 18 publications

References 24 publications

Diagnostic accuracy of cervical elastography in predicting preterm delivery

Diagnostic accuracy of cervical elastography in predicting preterm delivery

Emergency versus Elective Cervical Cerclage: An Audit of Our First Two Years of Service

Measuring leading placental edge to internal cervical os: Transabdominal versus transvaginal approach

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