Measurement of cervical length using transvaginal sonography for prediction of preterm labour

Abstract

Background: Preterm labour and delivery cause major health burden to the society due to high perinatal morbidities and mortality and long-term health implications and also affects maternal. An effective and objective way for predicting preterm delivery is measurement of cervical length by transvaginal sonography as it allows better quality and accurate visualization of uterine cervix. Cervical length (<25 mm) is good and accurate cervical biometry for prediction of preterm birth. The objective of this study was to measure cervical length by transvaginal sonography for predicting preterm labour and fetal outcome.Methods: This prospective observational study was conducted in department of obstetrics and gynaecology, at SVPIMSR hospital, Ahmedabad from July 2018 to December 2019 in 150 antenatal women to assess cervical changes (cervical length, dilatation of internal OS, funnelling etc.) between 16 to 24 weeks of gestation and these cases followed till delivery and results were analysed.Results:150 antenatal women who fulfilled the selection criteria were studied using transvaginal ultrasound between 16-24 weeks of gestation, out of them 36 (24%) women delivered preterm babies. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) recorded in this study were 80.5%, 94.73%, 82.85% and 93.91% respectively.Conclusion: Transvaginal sonography is the most useful and better, safe, accurate, most effective, less expensive, objective and acceptable technique for assessing cervical length in all antenatal women and predicting the preterm labour when assessed between 16 -24 weeks of gestational age.

Maternal BMI, 25-Hydroxyvitamin D serum level and Cervical Length Measurements: Markers for Preterm Delivery

“…(2020) studied 150 antenatal women and found that the CL (measured by TVUS between 16-24 weeks of gestation) was 25 mm in about 24% with PTD . 27 Similarly, Jafari et al (2015) found that the mean of uterine CL during the 2 nd trimester was 38.28 ± 5.13 mm . 28 In contrast to our study, Kwasan et al (2017) showed that the cut-off value of CL, in the prediction of preterm labor, was 30 mm with a sensitivity of 93.3% and specificity of 82.0%.…”

“…30 Similarly, Raval et al (2020) confirmed that TVUS was the most effective, useful, better, safe, accurate, less expensive, objective, and acceptable technique that was used for CL assessment in all antenatal women and also for predicting preterm labor when assessed between 16-24 weeks of gestational age . 27 Likewise, Hernandez-Andrade et al (2012) and Friedman et al (2013) concluded that TVUS is the superior and accurate method for CL assessment compared to TAUS . 31,32 Their results were in accordance with ours.…”