Value of transvaginal cervical ultrasonographic assessment and bacterial vaginosis in prediction of preterm birth

Abstract

Objective The objective of this study was to determine the diagnostic value of cervical length (CL) measurement, in the second trimester of pregnancy, and the impact of bacterial vaginosis (BV) as a preterm labor (PTL) predictor. Background Preterm birth is the leading direct cause of neonatal death and morbidity, and it imposes large costs to the healthcare system. Early detection of pregnant women at risk of PTL will help reduce the occurrence of prematurity-related mortality and morbidity. Cervical insufficiency and BV are two items that have been recently known to have an essential role in preterm delivery. They can be diagnosed using safe, simple, and reliable methods. Patients and methods This is a prospective cohort study that included 580 pregnant women with uncomplicated singleton pregnancy between 20 and 22 weeks of gestation to assess CL, which was measured by a transvaginal probe immediately after collecting a vaginal swab for the diagnosis of BV by Amsel's criteria. CL) less than 30 mm was considered a short cervix and suggested cervical insufficiency. The vaginal swab fulfilled three out of four Amsel's criteria and was considered positive for BV. Patients were followed up until delivery. Results Our final analysis was based on the results of 500 participants. The incidence of PTL was 100 out of 500 (20%). The incidence of PTL in women who had BV was 52 out of 100 (52%), which is statistically significant. The incidence of PTL in cases with short CL less than and equal to 30 mm was 39 out of 100 (39%), whereas the incidence of short cervix cases in full term was three out of 400 (0.8%), which was statistically significant. The incidence of PTL was 16% for cases with BV and short CL, whereas there were no cases for full-term labor, which is statistically significant ( P Conclusion The assessment of CL by transvaginal ultrasound and detection of BV during pregnancy have significant value in prediction of PTL.