Measurement of the uterocervical angle for the prediction of preterm birth in symptomatic women

Abstract

Purpose To examine if the uterocervical angle (UCA) can be used to predict preterm delivery in women with painful and regular uterine contractions and a cervical length of 25 mm or less. Methods Retrospective study at the perinatal unit of the University Hospital of Tuebingen, Germany. Women with singleton gestation and preterm contractions between 24 + 0 and 33 + 6 weeks’ gestation were included. For the UCA measurement, a line is placed from the internal os to the external os irrespective of whether the cervix is straight or curved. A second line is drawn to delineate the lower uterine segment. The angle between the two lines is the UCA measurement. The measurements were taken on stored images from our database. Results The study consisted of 213 singleton pregnancies. At the time of UCA measurement, median maternal and gestational age was 31.4 years and 29.7 weeks’ gestation. Median gestational age at delivery was 35.3 weeks and the corresponding birth weight 2480 g, respectively. The UCA measurement in women who delivered within 2 days, between 3–7 days and after 7 days was not helpful to distinguish between these three groups [median UCA measurements: 108.5°, 108.0° and 107.3° (Kruskal–Wallis test p = 0.576)]. Uni- and multivariate logistic multiple regression analysis demonstrated that the delivery within 2 days was only dependent on the gestational age and the cervical length at the time of presentation. Conclusion The measurement of UCA is not useful in predicting preterm birth in the subsequent 7 days after an episode of preterm contractions.

Uterocervical angle in predicting spontaneous preterm birth: a systematic review and meta-analysis

“…A total of 192 articles were retrieved from PubMed, Embase, the Cochrane database, WHO ICTRP, Web of Science, and ClinicalTrials.gov and through manual search. After excluding duplicates and ineligible studies, 22 studies were included in the qualitative analysis, including 11 prospective cohort studies, 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 7 retrospective cohort studies, 24 , 25 , 26 , 27 , 28 , 29 , 30 and 4 case-control studies. 31 , 32 , 33 , 34 Of note, 1 study was not included in the meta-analysis because of incomplete data.…”

Correlation between uterine wall thickness measured via trans-abdominal ultrasonography and cervical characteristics measured via trans-vaginal ultrasonography and Prediction of Preterm delivery

“…Regrettably, the data did not support any of these markers in the same way that our results did. 19 There is some confirmation, that a wider UCA is allied to PTB before 34 weeks of gestation. Daskalakis et al 20 assessed the existing body of literature about 3,000 women.…”

Uterocervical Angle Versus Cervical Length in the Prediction of Spontaneous Preterm Birth in Women with History of Spontaneous Preterm Birth. A Prospective Observational Study

“…Regarding the uterocervical angle, an acute angle reinforces the closure of the endocervical canal, while a more obtuse angle may facilitate the opening of the cervix (23); this could be the reason why Luechathananon et al, obtained a higher cutoff value compared to our study (110.97 ° vs 89.81 ° or 81) (22). In contrast to our study, results obtained by Wagner et al, showed that the uterocervical angle is not a useful measure for the prediction of preterm birth, the included patients in this study accounted for that difference as they included patients with regular uterine contractions and cervical length less than 25mm which indicated a very high risk for preterm delivery; an obtuse uterocervical angle was predominant in the three study groups that were delivery within 2 days, 3-7 days and after 7 days with corresponding median UCA angle of 108.5, 108°, and 107.3° (24). The value of these ndings is that when it comes to patients with already established uterine contractions and cervical changes, the value of the uterocervical angle in predicting preterm delivery is questioned.…”