Comparison of transperineal and transvaginal sonography in predicting preterm delivery

Yazici, Gürkan; Yıldız, Abdülkerim; Tiraş, M. Bülent; Arslan, Murat; Kanık, Arzu; Öz, Utku

doi:10.1002/jcu.20027

Cited by 25 publications

(20 citation statements)

References 24 publications

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“…8 Iams et al and Berghella et al concluded cervical length is inversely related to the risk of preterm birth in asymptomatic women. 1,9 In present study increment in cervical widths are noted in both patients who undergone term delivery and those having preterm delivery (except at 30wk) on follow up. However no significant difference is noted between both groups by TA and TV Us.…”

Section: Discussionsupporting

confidence: 56%

Cervical sonomorphometric evaluation of normal and preterm labour by transvaginal and transabdominal sonography

Khusboo

Kumar

Verma

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Preterm delivery is major cause of perinatal morbidity and mortality. Measuring cervical length (CL) with ultrasonography has become increasingly acceptable as an early diagnostic procedure in patients at risk for PTL, with transvaginal ultrasonography (TV Us) being considered as the gold standard for the CL assessment.Methods: A cohort of women with singleton pregnancies, and confirmed gestational age by first or early second trimester ultrasonography, last menstrual period & clinical assessment were selected to undergo transvaginal and transabdominal sonographic measurement of cervical length between 16 and 34 week gestation. Cervical length was first measured by transabdominal route (TAS) using a 3.5 MHz curved electronic array transducer with the patient in the supine position and with a full bladder, transvaginal sonography (TVS) was done by a 7.5 MHz probe attached to an ultrasound machine. The probe was covered with a latex condom and gel placed between the transducer and the cover and also on the surface. It was then gently inserted in the vagina to obtain a sagittal view of the cervix. Doppler measurement were taken by both transabdominal and transvaginal route.Results: Gradual decrease in cervical length is seen with advancement of gestation weeks. TA Us cervical length values are noted higher than TV Us however significance is seen only at 24 weeks and cervical width are showing gradual increase with advancement of gestation weeks without significant difference between them. The study compared the mean spectral Doppler parameters RI, PI and S/D Ratio at different weeks & observed that TV Us values are more at each gestation weeks than TA Us showing significant difference 24 weeks onwards.Conclusions: Although discrepancy in statistical significance, short cervical length, funneling and gland area are important to recognize for prediction of premature onset of labour, owing to the potential for perinatal morbidity and mortality and socioeconomic burden. Transvaginal sonography remains the dominant imaging modality for evaluation of the cervix. It is operator dependent modality so care should be taken to evaluate each morphologic character.

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Section: Discussionsupporting

confidence: 56%

Cervical sonomorphometric evaluation of normal and preterm labour by transvaginal and transabdominal sonography

Khusboo

Kumar

Verma

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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“…On TPU, the most important technical problem is the possible interference of adjacent bowel gas with cervical image 33 . The elevated lithotomy position helps to alleviate rectal gas overlying the external os.…”

Section: Introductionmentioning

confidence: 99%

“…TPU has been shown to have a sensitivity of 77% in predicting PTB with a false‐positive rate of 17% and a relative risk of 4.5 at the 32.5 mm cut off value 33 . In cases where a PROM is suspected or the patient declines the TV approach the TPU is useful.…”

Section: Introductionmentioning

confidence: 99%

Cervical length for predicting preterm birth and a comparison of ultrasonic measurement techniques

O'Hara

Zelesco²,

Sun

2013

Australas J Ultrason Med

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Introduction: Preterm birth is the leading cause of neonatal morbidity and mortality not attributable to congenital anomalies or aneuploidy. It has been shown that a shortened cervix is a powerful indicator of preterm births in women with singleton and twin gestations – the shorter the cervical length, the higher the risk of spontaneous preterm birth. Ultrasound measurements of the cervix are a more accurate way of determining cervical length (CL) than using a digital method. Background: There are three approaches that may be used to perform ultrasound measurements of the cervix; these are the transabdominal (TA), transperineal (TP) and the transvaginal (TV) approach. The TV approach is considered to be the gold standard. In women who are considered to be at a high risk of preterm birth it is now recommended that the cervix is measured at the mid‐trimester ultrasound using the TV ultrasound approach. For women considered to be at a historical low risk the TV scan is not recommended, however it has been found that many women who deliver a preterm baby have no known risk factors. Conclusion: There is contradictory evidence in the literature with regard to the correlation between TA, TP and TV measurements. This article provides an overview of these three approaches with a focus on the clinical value for the assessment of the maternal cervix.

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“…This method is reproducible, safe and more accurate than digital examination or abdominal or transperineal ultrasound [7,14,18,19] . Transvaginal ultrasound of the cervix also enables early detection of a shortening of the supravaginal portion of the cervix which is not amenable to clinical examination [20,21] .…”

Section: Discussionmentioning

confidence: 99%

Progressive Cervical Length Changes versus Single Cervical Length Measurement by Transvaginal Ultrasound for Prediction of Preterm Delivery

Dilek

Yazici

Gurbuz

et al. 2007

Gynecol Obstet Invest

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Background: To evaluate cervical length changes as predictors of preterm delivery. Methods: Two hundred and fifty-seven pregnant women underwent transvaginal ultrasound examination at 16 and 24 weeks of gestation. Cervical length was measured and the difference between the 2 measurements was calculated. The sensitivity, specificity, positive predictive value and negative predictive value of cervical length and cervical length changes were calculated and these methods were compared by receiver-operating characteristic (ROC) curve analysis. Results: Preterm delivery (before 37 weeks of gestation) occurred in 19 patients (7.4%). The mean cervical length was shorter in the preterm group, the area under the ROC curve for prediction of preterm delivery was 0.914, ultrasound had a sensitivity of 84.2% to predict preterm delivery with a false-positive rate of 18.5%, and the relative risk was 4.56 at the 34.3-mm cutoff value at 24 weeks of gestation. In contrast, a cervical length change on transvaginal ultrasound had a sensitivity of 73.3% to predict preterm delivery with a false-positive rate of 18.1%, and the relative risk was 4.08 at the 6.6-mm cutoff value. Conclusion: A single cervical length measurement obtained at 24 weeks of gestation can predict preterm delivery as accurately as cervical length change.

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Comparison of transperineal and transvaginal sonography in predicting preterm delivery

Abstract: When the cervix is well visualized, TPUS can predict preterm delivery as accurately as TVUS.

Cited by 25 publications

References 24 publications

Cervical sonomorphometric evaluation of normal and preterm labour by transvaginal and transabdominal sonography

Cervical sonomorphometric evaluation of normal and preterm labour by transvaginal and transabdominal sonography

Cervical length for predicting preterm birth and a comparison of ultrasonic measurement techniques

Progressive Cervical Length Changes versus Single Cervical Length Measurement by Transvaginal Ultrasound for Prediction of Preterm Delivery

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