Cervical Length For Prediction Research Articles

Diagnostic accuracy of posterior cervical angle, and cervical length in Prediction of Successful labor induction

Objective: To study the evaluation of the value of the posterior cervical angle, and cervical length, measured by transvaginal ultrasonography, compared with the Bishop Score in the prediction of successful labor induction.

Role of Preinduction Transvaginal Ultrasound Measurment of Cervical Length in Prediction of Labour Induction Success

Role of Preinduction Transvaginal Ultrasound Measurment of Cervical Length in Prediction of Labour Induction Success

Cervical Length as a Predictor of Success of Induction of Labor

Background: Vaginal delivery is the most important event occurring in women’s life. It carries many risks of significant concerns to the physicians. Predicting the chances of vaginal delivery is of paramount concern for the pregnant woman. Antenatal cervical length measurement has paramount importance in the prediction of labor. Objective: This study aimed to study the role of cervical length in prediction of success of induction of labor in term pregnancy. Patients and Methods: A prospective study where 140 pregnant women undergoing induction of labor for various indications were included, the cases were recruited from Obstetric Department of Shebin El-Kom Teaching Hospital in the period from October 2019 to December 2020. Results: Methods of induction was misoprostol in (75) females and amniotomy with oxytocin in (65) females. 97 Females were delivered by simple vaginal delivery, 79 females were delivered within 24 hours of induction, 18 females were delivered after 24 hours, and 43 females were delivered by caesarian section (C.S.). Indications of C.S. were mainly due to failed induction and fetal distress. Conclusions: We concluded that successful induction of labor was correlated significantly with detection of insulin-like growth factor-binding protein 1 (iGFBP-1) in cervical secretions and measurement of cervical length by transvaginal ultrasound (TVUS), IGFBP-1 detection by Actim Partus test is simple, easy bed side test that can predict successful induction of labor and measurement of cervical length by TVUS is a good predictor factor for successful induction of labor.

Transvaginal ultrasound cervical length for prediction of spontaneous labor at term: A protocol for systematic review and meta-analysis.

Purpose:To evaluate the predictive accuracy of transvaginal ultrasound (TVU) cervical length (CL) for spontaneous onset of labor in singleton gestation enrolled at term by a meta-analysis.Materials and methods:This protocol established in this study has been reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Web of Science, PubMed, EMBASE, and the Cochrane Library were searched for all clinical trials assessing the accuracy of TVU CL in prediction of spontaneous onset of labor in singleton gestations with vertex presentation who were enrolled at term until August 15, 2020. We will use a combination of Medical Subject Heading and free-text terms with various synonyms to search based on the eligibility criteria. Two investigators independently reviewed the included studies and extracted relevant data. The 95% confidence intervals (CIs) of was used as effect estimate. I-square (I2) test, substantial heterogeneity, sensitivity analysis, and publication bias assessment will be performed accordingly. Stata 15.0 and Review Manger 5.3 are used for meta-analysis and systematic review.Results:The results will be published in a peer-reviewed journal.Conclusion:The results of this review will be widely disseminated through peer-reviewed publications and conference presentations. This evidence may also assess the accuracy of TVU CL in prediction of spontaneous onset of labor in singleton gestations with vertex presentation.Registration number:INPLASY202080065

Insulin-Like Growth Factor Binding Protein-1 versus Cervical Length in Prediction of Successful Induction of Labor after 37 Week. Observational Study

Bishop Score is still the usual method to expect the results of labor induction. Transvaginal ultrasonographic measurement of cervical length (TVUS-CL) is more objective and insulin like growth factor binding protein-1(IGFBP-1) has been recently used for this aim.

Insulin-Like Growth Factor Binding Protein-1 versus Cervical Length in Prediction of Successful Induction of Labor after 37 Week. Observational Study

Background: Bishop Score is still the usual method to expect the results of labor induction. Transvaginal ultrasonographic measurement of cervical length (TVUS-CL) is more objective and insulin like growth factor binding protein-1(IGFBP-1) has been recently used for this aim. Objective: This study was conducted to compare between TVUS-CL and detection of cervical (IGFBP-1) for prediction of results of induction of labor after 37 week of pregnancy. Patients and Methods: A prospective cohort study on 140 pregnant women underwent induction of labor. All patients were subjected to TVUS-CL and detection of cervical (IGFBP-1) and Bishop Score. The primary outcome measure was induction success. The secondary outcome measure was induction to delivery interval. Results: In our study (97) females delivered by simple vaginal delivery (SVD), (79) females delivered within 24 hour of induction, (18) females delivered after 24 hour, and (43) females delivered by caesarian section. The mean cervical length measured by TVUS in females who delivered by SVD was 24.89 ±5.48 mm and was 26.79±3.06 mm in those who delivered by CS. IGFBP-1 was positive in 71 females who delivered by SVD and in 17 females who delivered by CS and it was negative in 26 females who delivered by SVD and 26 females who delivered by CS. Conclusion: Success of labor induction correlated significantly with detection of cervical IGFBP-1 and measurement of cervical length by TVUS.

Transvaginal Sonographic Assessment of the Cervix for Prediction of Successful Induction of Labor in Nulliparous Women

Background: Induction of labor is commonly performed in obstetric practice. Many methods have been suggested as good predictors of the outcome of labor induction, yet none of them is satisfactory enough. Our study aims to assess cervical length and uterocervical angle measured by transvaginal ultrasound as predictors of successful induction of labor. Methods: Prospective cohort study conducted in Ain Shams University Maternity hospital over 150 nulliparous women undergoing induction of labor, in the period between May 2018 and August 2019. Transvaginal sonographic measurement of cervical length and uterocervical angle was done before induction of labor by prostaglandins. The patients were followed up till delivery and the outcome was recorded. Results: The best cut-off value of cervical length for prediction of success of labor induction was 32.3 mm with 60% sensitivity and 56% specificity and the best cut-off value of uterocervical angle was 110.2 degrees with 87% sensitivity and 93% specificity. The cervical length showed a significant negative correlation while the uterocervical angle showed a significant positive correlation with the success of labor induction. Conclusion: Cervical length and uterocervical angle are good predictors of successful labor induction.

Evaluation of additive effect of quantitative fetal fibronectin to cervical length for prediction of spontaneous preterm birth among asymptomatic high-risk women

Objective: To determine if quantitative fetal fibronectin (qFFN) in addition to transvaginal ultrasound (TVU) cervical length (CL) measurement between 180/7 and 236/7 weeks would be predictive of spontaneous preterm birth (sPTB) at <350/7 weeks among asymptomatic high-risk women as defined by those with prior sPTB > 200/7 weeks.Material and methods: A prospective observational study of asymptomatic women with singleton gestations between 180/7 and 236/7weeks and one or more prior SPTB was performed. Women at their anatomy scan who opted into universal CL screening were enrolled. At enrollment, a vaginal speculum exam was performed to collect cervico-vaginal fluid from the posterior fornix using fetal fibronectin (FFN) swab. These women were then followed until delivery. Women with multiple gestations, rupture of membranes, vaginal bleeding, intercourse, or vaginal exam within 48 h of enrollment were excluded. Physicians were blinded to the qFFN levels, but the CL measurements were made available. The primary outcome was sPTB < 350/7 weeks.Results: Of the 105 asymptomatic women with prior sPTB who were prospectively enrolled, 19 (18.1%) had recurrent sPTB < 370/7 weeks. None of the sPTB were iatrogenic. Using receiver-operating characteristic curves, qFFN ≥ 10 ng/mL had the highest sensitivity with subsequent lowest false negative rate, while FFN ≥ 50 ng/mL was identified as being the best balance of sensitivity and false positive rate for predicting sPTB < 350/7 weeks. As compared with CL ≤ 25 mm alone, with the use of CL ≤ 25 mm or qFFN ≥ 50 ng/mL as screening criteria for prediction of SPTB < 350/7 weeks, sensitivity improved from 18.2 to 63.6%, specificity decreased from 96.8 to 82.1%, positive predictive value (PPV) decreased from 40.0 to 29.2%, negative predictive value (NPV) marginally improved from 91.1 to 95.1%.Conclusion: In women with singleton gestations with prior SPTB, qFFN can be used as an adjunct to triage patients who are found to have a shortened cervix. Sensitivity and NPVs improved with the addition of qFFN to TVU CL screening alone in women with singleton gestations with prior SPTB. However, specificity and PPVs decreased.

Assessment of cervicovaginal HCG and cervical length in prediction of labour

Assessment of cervicovaginal HCG and cervical length in prediction of labour

Transvaginal ultrasound cervical length for prediction of spontaneous labour at term: a systematic review and meta-analysis.

The possibility to predict the delivery date is a question frequently raised by pregnant women. However, a clinician has currently little to predict when a woman at term will deliver. To evaluate the predictive accuracy of transvaginal ultrasound (TVU) cervical length (CL) for spontaneous onset of labour in singleton gestation enrolled at term by a meta-analysis. We performed a literature search in electronic databases. We included only studies assessing the accuracy of TVU CL in prediction of spontaneous onset of labour in singleton gestations with vertex presentation who were enrolled at term. The primary outcome was the accuracy of CL for prediction of spontaneous labour within 7days. Pooled sensitivities and specificities were calculated. Five studies including 735 singleton gestations were included. For the prediction of spontaneous labour within 7days for CL <30mm the pooled sensitivity was 64% and pooled specificity was 60%. The higher the CL, the better the sensitivity; the lower the CL, the better the specificity. A woman with a singleton gestation at term and a TVU CL of 30mm has a <50% chance of delivering within 7days, while one with a TVU CL of 10mm has an over 85% chance of delivery within 7days. TVU CL at term has moderate value in predicting the onset of spontaneous labour. A woman with a TVU CL of 10mm or less has a high chance of delivering within a week. Cervical length at term has moderate value in predicting the onset of spontaneous labour.

Cervical length in prediction of preterm birth after laser surgery for twin-twin transfusion syndrome.

To determine the risk factors for spontaneous preterm delivery (PTD) or preterm prelabor rupture of membranes (PPROM) at < 34 weeks' gestation after fetoscopic laser surgery for twin-twin transfusion syndrome and to identify the optimal threshold for preoperative cervical length (CL) that indicates a high risk for spontaneous PTD. This was a secondary analysis of data prospectively collected from 449 patients at three fetal centers. CL measurements were obtained by preoperative transvaginal ultrasound, at a gestational age of 16-26 weeks. The risk factors associated with spontaneous PTD before 34 weeks' gestation were determined using multivariable logistic regression analysis. We excluded patients with dual fetal demise and those with maternal or fetal indications for delivery without PPROM (n = 63). The optimal threshold for cervical length to predict spontaneous PTD before 34 weeks was determined using a receiver-operating characteristics (ROC) curve and Youden index. Additionally, the CL threshold for spontaneous PTD at 2-week intervals between 24 and 34 weeks was determined. Spontaneous PTD before 34 weeks occurred in 206 (53.4%) of the included patients. Only the preoperative CL was significantly associated with spontaneous PTD. The preoperative CL was normally distributed with a mean of 37.6 ± 10.3 mm (range, 5-66 mm). Maternal age and parity were positively associated, and gestational age at procedure and anterior placenta were negatively associated, with CL on multivariable linear regression analysis. The area under the ROC curve for predicting spontaneous PTD with CL measurements was 0.61 (P = 0.02) and the optimal threshold was 28 mm with a Youden index of 0.19 (sensitivity and specificity of 92% and 27%, respectively). A CL measurement of < 28 mm increased the risk of spontaneous PTD for all gestational age thresholds. Spontaneous PTD at < 34 weeks' gestation is associated with a preoperative CL of < 28 mm. Preventive strategies should focus on this high-risk group.

Cervicovaginal HCG and cervical length for prediction of preterm delivery in asymptomatic women at high risk for preterm delivery

To predict the risk of preterm birth (<37 weeks) or early preterm birth (<34 weeks) by cervicovaginal HCG and cervical length measured between 24-28 weeks of gestation in asymptomatic women at high risk for preterm birth. This study was conducted in the departments' of Obstetrics & Gynaecology and Immunopathology of the Postgraduate Institute of Medical Education and Research, Chandigarh, India. In 75 pregnant women at high risk for preterm birth because of prior one on more preterm births due to spontaneous labour or ruptured membranes, cervicovaginal HCG and cervical length (by TVS) were measured between 24-28 weeks of gestation. These parameters were correlated individually and in combination for prediction of preterm birth. Of the 75 women, 20 (26.7%) delivered <37 weeks and 6 (8%) delivered <34 weeks. To predict delivery <37 weeks, cervical length <2.95 cm had a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 75%, 80.1%, 71.4% and 90.7% respectively, and cervicovaginal HCG >4.75 mIU/ml had a sensitivity, specificity, PPV, and NPV of 70%, 61.81%, 40% and 85% respectively. To predict delivery <34 weeks, cervical length <2.65 cm had a sensitivity, specificity, PPV, and NPV of 50%, 85.50%, 23.08% and 95.16% respectively; and cervicovaginal HCG >14 mIU/ml had a sensitivity, specificity, PPV and NPV of 83.3%, 85.5%, 33.3% and 98.3% respectively. Cervical length was superior to predict delivery <37 weeks, whereas HCG was superior to predict delivery <34 weeks. Their combination was superior to predict preterm birth both <37 weeks or <34 weeks, than either parameter used alone. In high risk asymptomatic women, increased cervicovaginal HCG and reduced cervical length and between 24 to 28 weeks of gestation increased the risk of preterm delivery.

Ultrasound cervical measurement and prediction of spontaneous preterm birth in ICSI pregnancies: a prospective controlled study

A prospective controlled study was performed in which transvaginal ultrasound measurement of cervical length was compared in 222 twin ICSI pregnancies, 122 singleton ICSI pregnancies and 51 spontaneous singleton pregnancies. Preterm birth was defined as ≤34 weeks. Full data were obtained for 193 twin pregnancies (group A), 102 singleton pregnancies (group B) and 51 spontaneous singleton pregnancies (group C). Cervical length at midterm was not statistically different between the three groups: group A, 37.6 ± 7.1 mm; group B, 37.2 ± 7.2 mm; and group C, 39.2 ± 5.4 mm. The incidence of preterm birth was statistically different between groups: 30.5% in group A; 17.6% in group B; and 3.9% in group C ( P = 0.011). The ROC curve for optimum cut-off of cervical length in prediction of preterm birth for group A was 38.05 mm, sensitivity 67%, specificity 50%, positive predictive value (PPV) 37.7, and negative predictive value (NPV) 78.1. For group B the data were 33.05 mm, sensitivity 50%, specificity 70%, PPV 34.6, and NPV 88.1. Contrary to the situation for spontaneous pregnancies, midtrimester cervical length measurement in ICSI singleton and twin pregnancies is not a predictor for preterm birth.

P03.14: Sonographic cervical length in prediction of preterm delivery: centiles versus single cut‐offs measurements

P03.14: Sonographic cervical length in prediction of preterm delivery: centiles versus single cut‐offs measurements