Comparison between different methods of sonographic cervical length assessment during pregnancy

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Abstract

Objectives

The objective of this work was to compare the different methods of assessment of cervical length (transabdominal, transvaginal, and transperineal) during pregnancy as a possible screening for preterm birth.

Design

The study design was a prospective cohort one.

Setting and population

The study was performed on 200 cases who attended El-Shatby Hospital at gestational age ranging from 20 to 26 weeks. There was no significant difference with regard to demographic data (maternal age, parity, etc.). The route of examination was started according to urinary bladder fullness at admission. Accordingly, the patient was not instructed to void if she had full bladder, rather we started examination through the transabdominal route. If she had an empty bladder at the time she presented, we started examination through the transperineal route followed by the transvaginal route. The four measurements were compared with each other and the difference between them calculated.

Sample size

The sample size was found to be 200 pregnant women.

Results

The transvaginal route gave the longest cervical measurements, followed by the transperineal route and the transabdominal route-full bladder and finally the transabdominal route-semifull bladder. Our results indicate that there is a significant positive correlation among the four methods of measuring cervical length in those gestational ages.

Conclusion

Transabdominal assessment could be used initially for cervical length screening, considering the maternal and fetal condition. Thereafter, if the need arises, transvaginal sonography could be used. This step-by-step approach may be more convenient and useful to both patients and physicians for cervical length screening.

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