Can transvaginal ultrasonographic evaluation of the endocervical glandular area predict preterm labor among patients who received tocolytic therapy for threatened labor: a cross-sectional study

Abstract

Objective: Increased neonatal morbidity and mortality rates resulting from preterm delivery (PTD) remain as a problem despite increasing evidence about the physiology of uterine contractility process. More predictive signs of preterm labor detected on prenatal ultrasonography like the presence of cervical gland area (CGA) on transvaginal ultrasonography can be a reassuring finding among patients with threatened labor risk.Methods: In this prospective study, 85 pregnant patients at 24–34 weeks of gestation who attended to our high risk pregnancy clinic for threatened labor between March 2011 and March 2012 have been examined by transvaginal ultrasonography to evaluate CGA located around the endocervical canal. Following discharge, the gestational week at birth, birth weight and birth route of patients have been recorded.Results: Among patients with a cervical length (CL) <30 mm and ≥30 mm measured by transvaginal ultrasonography on admission, 82.4% of the patients with a short cervix exhibiting echolucent endocervical glandular area and 42.3% of the patients with short cervix exhibiting echogen endocervical glandular area on sonography delivered at term (p = 0.013).Conclusion: The presence of CGA detected on transvaginal ultrasonography especially when combined with the evaluation of CL during the management of patients with threatened labor can be a reassuring sign for actual probability of PTD.