Cervical Evaluation By Transvaginal Ultrasonography as a Predictor of Preterm Labour

  • Duleep Bhonsale Additional Professor, Department of Radiology,HBT Medical College & Dr. R.N. Cooper Municipal Gen. Hosp. Mumbai 400056
  • Pooja Jaisal Assistant Professor, Department of Obstetrics & Gynaecology, HBT Medical College & Dr. R.N. Cooper Municipal Gen. Hosp. Mumbai 400056
Keywords: Cervical length, Funneling, Transvaginal Ultrasonography (TVS), preterm labour

Abstract

Aims and Objective:  To determine the efficacy of TVS ultrasonographic evaluation of cervical biometry in predicting preterm delivery in asymptomatic low risk pregnant women. Material and Methods - a prospective analysis of low- risk pregnant patients at 22-24 weeks attending antenatal OPD at a tertiary level teaching hospital over a period of one year. There were 200 antenatal patients overall equally divided into two groups GrA with 100 patients and cervical length< 2.5cm and GrB with 100 patients having cervical length >/= 2.5cm. Transvaginal ultrasonography was performed and cervical evaluation done by measuring cervical length and recording presence or absence of funnelling. These women were followed till delivery and results analysed by finding p-value. Results: The results proved that with cervical length, 2.5cm the preterm deliveries were 88% while term deliveries were only 12%. This was statistically significant with a P-value of < 0.001. Of the 88 patients that had preterm delivery, in 36 patients there was presence of funneling and only 2 of these could carry their pregnancies till term and 34 of them ie.  94.4% had preterm deliveries. In patients with cervical length >/= 2.5cm the total preterm delivery rate was only 8% in asymptomatic pregnant women and the term deliveries were 92%. Of the Preterm deliveries in this group 2 (25%) had funneling while in 6 (75%) it was absent.

Conclusion: This study has re-established the relevance of TVS in cervical assessment for prediction of preterm labour.

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References

1. Leitch H. Secondary predictors of preterm labour. Br J Ostet Gynecol. 2005 Mar;112:48-50.
2. Iams JD, Goldenberg RL, Meis PJ, et al. The length of the cervix and the risk of spontaneous premature delivery. N Engl J Med 1996;334: 562–572.
3. Blencowe H, Cousens S, Oestergaard M, Chou D, Moller AB, Narwal R, Adler A, Garcia CV, Rohde S, Say L, Lawn JE. National, regional and worldwide estimates of preterm birth. The Lancet, June 2012. 9;379(9832):2162-72. Estimates from 2010.
4. Blondel B, du Mauzaubrun C, Bréart G. Enquête nationale périnatale 1995. Rapport de fin d'étude. INSERM Edition. Paris : INSERM, 1996.
5. Stanley FJ. Cerebral palsy: the courts catch up with sad realities. Med J of Aust 1994;161: 236.
6. Kramer MS, Platt R, Yang H, et al. Secular trends in preterm birth: a hospital-based cohort study. JAMA 1998;280:1849–1854.
7. National Vital Statistics Report 2002;50: No. 5. 10.
8. Kore SJ, Parikh MP, Lakhotia S, Kulkarni V, Ambiye VR. Prediction of risk of preterm delivery by cervical assessment by trans vaginal ultrasonography. J Obstet Gynecol India. 2009;59:131–5.
9. Iams JD, Goldenberg RL, Meis PJ, Mercer BM, Moawad A, Das A, et al. The length of the cervix and the risk of spontaneous premature delivery. National Institute of Child Health and Human Development Maternal Fetal Medicine Unit Network. N Engl J Med. 1996;334:567–72.
10. Tanveer SG, Samal S, Armugam S, Parida P. Measurement of cervical biometry using transvaginal USG in predicting preterm labour. J Nat Sci Bio Med. 2014;5(2):369-72
11. Althuisius SM, Dekker GA, Hummel P, Bekedam DJ, van Geijn HP. Final results of the Cervical Incompetence Prevention Randomized Cerclage Trial (CIPRACT): therapeutic cerclage with bed rest versus bed rest alone. Am J Obstet Gynecol2001;185: 1106–1112.
Published
2016-09-28
How to Cite
1.
Bhonsale D, Jaisal P. Cervical Evaluation By Transvaginal Ultrasonography as a Predictor of Preterm Labour. IABCR [Internet]. 28Sep.2016 [cited 19Jul.2019];2(3):93-5. Available from: https://iabcr.org/index.php/iabcr/article/view/181