Relationship between Uterocervical Angle and Prediction of Spontaneous Preterm Birth

Abstract

Aim: This study aimed to determine whether a novel ultrasonographic marker, uterocervical angle, correlates with risk of spontaneous preterm birth. Materials and Methods: In the present prospective, cohort, study, we included 197 singleton pregnant women at Ain shams university maternity hospital (outpatient obstetrics clinics and emergency department. The mean age of the included women was 27.2 ± 4.8 years while the mean party was 2.2 ±1.3. The mean BMI was 33.4 ± 2.6Kg/m2. Results: In the present study, we found that there were statistically significant differences between both groups in terms of history of preterm labor (p <0.001) and tobacco smoking (p =0.008). Smokers and women with history of PTB had higher risk of PTB. In our report, there were statistically significant differences between both groups in terms of neonatal mortality. With regard to the primary outcome of the present study, we found that there was statistically significant difference between women with spontaneous preterm labor and women with term deliveries regarding UCA (p =0.015). Mean UCA in the second trimester was wider in the preterm group compared with the control group. The UCA was a significant discriminator of preterm labor. At cut-off value of ≥ 105, the GP37 yielded a sensitivity of 86.7% and specificity of 89% for the discrimination between preterm and term deliveries. Conclusion:Wider UCA in the second trimester is related to spontaneous PTB. UCA measurement is a reproducible technique. UCA appears to increase from the first to the second trimester.

Uterocervical angle and cervical length measurements for preterm birth prediction in low-risk singleton pregnant women: A prospective cohort study

“…As shown in Table 1, the mean CL was signi cantly shorter in the participants who delivered preterm than in those who delivered at term, and the mean UCA was signi cantly greater in those who delivered preterm. These results were in agreement with the ndings of previous studies conducted in unselected singleton pregnant women; the UCA was signi cantly wider in singleton pregnant women with spontaneous PTB [21][22][23][24][25]. The combination of pressure applied the surrounding pelvic organs, more importantly from the growing uterus during pregnancy, could result in the alteration of the internal ostium (os) and cervical function [26].…”

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.…”

“…All 22 studies included in the qualitative analysis compared UCA in sPTB and term births, with 18 studies showing a statistically significant difference 13 , 15 , 16 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 27 , 29 , 30 , 31 , 32 , 33 , 34 and 4 studies showing no difference. 14 , 17 , 26 , 28 Of note, 21 studies were included in the quantitative analysis, as shown in Figure 2 .…”

“… 14 , 17 , 26 , 28 Of note, 21 studies were included in the quantitative analysis, as shown in Figure 2 . 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 29 , 30 , 31 , 32 , 33 , 34 Of the 6895 patients included, UCA was significantly larger in the sPTB group than in the term birth controls (MD, 13.76; 95% confidence interval [CI], 10.61–16.91; P <.00001; I 2 =90%). There was significant heterogeneity in GA cutoffs for PTB, GA at the initial US, and both number of gestations and whether patients had symptoms of preterm labor.…”

“…Of note, 16 studies included in the qualitative analysis compared UCA in sPTBs and term births in singleton pregnancies, 13 , 14 , 15 , 16 , 18 , 19 , 21 , 22 , 23 , 26 , 28 , 30 , 31 , 32 , 33 , 34 with 14 studies showing a statistically significant difference 13 , 14 , 15 , 16 , 18 , 19 , 21 , 22 , 23 , 26 , 28 , 30 , 31 , 32 , 33 , 34 and 2 studies showing no difference. 14 , 26 Of the 16 studies, 15 were included in the quantitative analysis, as shown in Figure 3 .…”