Two-step test: the combined use of fetal fibronectin and sonographic examination of the uterine cervix for prediction of preterm delivery in symptomatic patients

Transvaginal cervical length measurement for prediction of preterm birth in women with threatened preterm labor: a meta‐analysis

“…Sixteen of them included ultrasound examination of the cervix only 7,15 -29 and 12 included both ultrasound examination and biochemical testing 30 -41 . Three of these studies met the eligibility criteria but could not be used for data synthesis, either because their outcome was not included in the design of the meta-analysis 38 , or because there were fewer than two studies per outcome and therefore the data could not be integrated 24,32 .…”

Ultrasound assessment of cervical length in threatened preterm labor

“…An observational study of 65 women presenting with preterm labor and treated with tocolytics at 26-35 weeks reported that the mean cervical length on admission in those with successful tocolysis was 27 (range, 9-45) mm, compared to 9 (range, 6-12) mm in the unsuccessful group 8 . Another study of 82 women presenting with preterm labor and treated with tocolytics at 24-34 weeks reported that the cervical length on admission was ≤ 20 mm in 57% of the 14 women that delivered within 28 days, compared to 7% in the 68 that delivered after 28 days 9 . Similarly, a study of 108 women presenting at 24-36 weeks reported that the cervical length on admission was ≤ 20 mm in 68% of the 47 women that delivered before 37 weeks, compared to 21% in the 61 that delivered at term 10 .…”

Screening for Preterm Labor

“…28,29 In contrast, Crane et al, 25 and Hincz et al, 23 reported that funneling was not an independent predictor of preterm delivery in symptomatic women. Hincz et al, 23 also observed that there was a higher incidence of funneling with the advance of gestational age, a finding which was first seen by Iams et al,30 who reported that funneling is probably normal after 32 weeks of gestation. Moreover, Berghella et al, 31 found that although funneling was a good predictor of preterm delivery in the second trimester, it was of limited value in symptomatic patients after 32 weeks.…”

“…They reported that the combined use of the cervical ultrasonography and fFN testing improves the diagnostic efficiency of any of these methods alone. 22,23 More recently, Rozenberg et al, 24 in a similar study of 76 symptomatic patients, failed to show any significant additional benefit from the performance of fFN testing over the single transvaginal ultrasonographic measurement of cervical length. Crane et al, 25 evaluated singleton and twin pregnancies with preterm contractions and found that transvaginal sonographic measurement of the cervix was a good predictor of preterm delivery and it had a better predictive value in singletons than in twins.…”