An additional approach of repeat digital examination for preterm labor. Comment on Volumenie et al. [Eur J Obstet Gynecol RB 117 (2004) 33–7

Abstract

We read with great interest the article by Volumenie et al. [ [1] Volumenie J.L. Luton D. Spirlet M.D. Sibony O. Blot P. Oury J.F. Ultrasonographic cervical length measurement is not a better predictor of preterm delivery than digital examination in a population of patients with idiopathic preterm labor. Eur J Obstet Gynecol RB. 2004; 117: 33-37 Abstract Full Text Full Text PDF PubMed Scopus (32) Google Scholar ]. Most studies that have compared digital and ultrasonographic examination of the cervix for the prediction of preterm delivery without distinguishing the population based on the likelihood of preterm delivery, supported the dominance of the latter examination. However, Volumenie's study related that ultrasonographic cervical length measurement is not a better predictor of preterm delivery than digital examination especially in the high-risk population. Recently, Rozenberg suggested that repeating ultrasonographic cervical length measurement after successful tocolysis for preterm labor is useless [ [2] Rozenberg P. Rudant J. Chevret S. Boulogne A.I. Femme S. Ville Y. Repeat measurement of cervical length after successful tocolysis. Obstet Gynecol. 2004; 104: 995-999 Crossref PubMed Scopus (18) Google Scholar ]. In Rozenberg's study, subjects were also inferred to be of the high-risk population as in Volumenie's study because of the gestation with a cervical length on admission and the agreement of preterm delivery rates. Accordingly, Volumenie's study would have become better research if an investigation of repeat digital examination of cervical length for preterm labor had been added to their study. Reply to Dr. Shukunami concerning “Ultrasonographic cervical length measurement is not a better predictor of preterm delivery than digital examination in a population of patients with idiopathic preterm labor” [Eur J Obstet Gynecol Reprod Biol 2004;117:33–7]European Journal of Obstetrics and Gynecology and Reproductive BiologyVol. 120Issue 1PreviewWe thank Dr. Shukunami for his interest in our study and greatly appreciate the relevant remarks made. We did not use the results of repeat digital examination, although such an examination was generally performed on discharge. Theoretically, it could have been of interest, in order to analyse the clinical utility of this attitude, as Rozenberg et al. did for ultrasonography [1]. Full-Text PDF