W123 Screening of Preterm Labor in Yazd Province: Transvaginal Ultrasound Assessment of the Cervix in the Second Trimester

Abstract

Background: Spontaneous preterm labor is one of the common obstetrics problems causing several physical, psychological and economical outcomes. Although due to these outcomes and the efficacy of cares for decreasing them, preterm labor screening is cost-effective and it is still one of the challenging issues in obstetrics. Objective: In this study preterm labor screening by using cervical transvaginal sonography was evaluated. Materials and Methods: This observational cohort study was performed in Yazd, Iran. Samples were selected from pregnant women at gestational age of 21-24 weeks who had single live fetus and referred to the obstetrics clinics of two selected hospitals in Yazd. Gestational age was estimated based on the sonography of the first trimester and cervical length measured by transvaginal sonography. Data analysis was done by using t and x2 test as well as ANOVA. Statistical significant level was considered as p<0.05. Results: From 450 participants, 47 cases had preterm labor and 6 cases had positive funneling. Mean age of women with term labor was 26.09±4.13 years and that of women with preterm labor was 26.7±3.51 years (p=0.334). Duration of pregnancy and cervical length significantly differed between women with and without funneling (p=0.001). The sensitivity and specificity of screening based on cervical length of 25mm were 55.5% (50.9-60.1%) and 93.6% (91.2-96%) respectively. Conclusion: Based on the results of the present study, transvaginal ultrasound assessment of cervical length in low risk women has an acceptable reliability for screening of preterm labor.

Role of Ultrasonographic Evaluation of Cervical Features and Myometrial Thickness in Prediction of Preterm Birth

“…In Dalili et al 1 study, 12% of spontaneous preterm birth women had positive funneling. Duration of pregnancy and cervical length significantly differed between women with and without funneling.…”

“…In our study, the predictive role of cervical length measurement in mm was evaluated by ROC curve in group B between 20 to 24 weeks cervical length < 26 mm has sensitivity 100%, specificity 48.9%, PPV 17.9% and the NPV 100% with 54% accuracy. The sensitivity and specificity of cervical length measurement of 25 mm in low risk women was calculated in Dalili et al 1 study, they were 55.5% and 93.6% respectively. Barber et al 10 found that a cervical length of ≤25mm at 24 weeks had a sensitivity of 37%, a specificity of 92%,a positive predictive value 18%, and a negative predictive value 97 % in the prediction of spontaneous preterm labor at <35weeks' gestation.…”

“…Some of them are early threatened abortion in the current pregnancy, genetic factors, demographic features and behavior. 1 The human cervix is a dynamic organ as its structure and shape change throughout the pregnancy period. It softens, shortens, dilates and becomes thinner as pregnancy progresses and term approaches.…”

The effect of prenatal self-care based on orem's theory on preterm birth occurrence in women at risk for preterm birth

“…[ 13 15 ] Universal self-care requisites are found in all humans and are associated with processes of individuals' lives and general welfare. [ 16 ] Universal self-care deficits in pregnancy include malnutrition in pregnancy,[ 6 ] alcohol usage, drug use, inadequate intake of healthy air in situations where there is smoking,[ 17 ] ambient poisons,[ 5 ] sulfur dioxide,[ 18 ] imbalance between activity and rest such as prolonged standing and walking,[ 19 ] intense physical activity and night work,[ 20 ] occupational tiredness,[ 10 ] risks for pregnant women during pregnancy such as hitting,[ 21 ] anxiety,[ 22 ] depression,[ 23 ] stress, and lack of social support and relationships. [ 5 ] These cases are among the predisposing factors for the incidence of preterm birth.…”

Cervical gland area as an ultrasound marker for prediction of preterm delivery: A cohort study

“…Cervical length and cervical funneling are the most parameters evaluated. Dalili and coworker showed a significant relationship between cervical length at second trimester and PTL risk ( 6 ). Shortening of the cervical length reflect cervical maturation and is a valuable criterion of the PTL, however, it is not solely criterion.…”