MID-TRIMESTER CERVICAL LENGTH ASSESSMENT USING TRANSVAGINAL SONOGRAPHY: A PREDICTOR FOR PRETERM LABOR IN ASYMPTOMATIC SINGLETON PREGNANCIES
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Keywords
Cervical Length, Preterm Delivery, Singleton Pregnancy, Transvaginal Ultrasound
Abstract
Background and Aim: Preterm delivery presents a considerable challenge in obstetrics globally, leading to a range of complications for newborns during their neonatal period and potentially impacting their health throughout their lives. The length of the cervix is recognised as a key indicator of the risk for preterm labour. Transvaginal sonography (TVS) offers a more precise and timely detection of cervical length shortening compared to traditional digital assessment methods. This study focused on assessing the length of the cervical canal through transvaginal sonography in singleton pregnancies occurring between 18 and 26 weeks of gestation.
Material and Methods: This research aimed to assess the efficacy of cervical length as a predictor for pre-term labour. Cervical length assessment is conducted using transvaginal ultrasound techniques. Patients with a length of less than 25 mm were recommended to undergo a second scan at the 28th week, with follow-up continuing until delivery.
Results: The findings indicate that the majority of patients were within the 25-30 year age range. The distinction is considered statistically significant when the p-value is less than 0.05. Research indicates that patients exhibiting reduced cervical length in the mid-trimester face an increased likelihood of experiencing pre-term delivery. The area under the fitted curve is 0.8, with an estimated standard error of 0.06. The sensitivity is reported at 61%, while the specificity stands at 8.85%. The positive predictive value is 57.50%, and the negative predictive value is 89.90%.
Conclusion: Research indicates that cervical length serves as a predictor for the risk of preterm delivery in women who do not exhibit any symptoms. Transvaginal ultrasound has proven to be an effective, safe, and straightforward noninvasive outpatient procedure for measuring cervical length.
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Dr. Steffi Gandhi
Assistant Professor, Department of Obstetrics and Gynaecology, Parul Institute of Medical Sciences and Research, Parul University, Vadodara, Gujarat, India
Dr. Devangi Dipakkumar Panchal
Postgraduate Second Year Resident, Department of Obstetrics and Gynaecology, Parul Institute of Medical Sciences and Research, Parul University, Vadodara, Gujarat, India
Dr. Namrata Khimjibhai Gabu
Postgraduate Second Year Resident, Department of Obstetrics and Gynaecology, Parul Institute of Medical Sciences and Research, Parul University, Vadodara, Gujarat, India
Dr. Priyank R Pancholi
Associate Professor, Department of Orthopaedics, Parul Institute of Medical Sciences and Research, Parul University, Vadodara, Gujarat, India