Transvaginal Ultrasonographic Measurement Of Cervical Length Research Articles

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.

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.

The Effect of Ultrasound-Measured Preinduction Cervical Length on Delivery Outcome in a Low-Resource Setting

Background Induction of labour is not without risk, and it calls for a method that will be sensitive enough to predict successful labour induction. Aim This study aims to evaluate the role of transvaginal ultrasonographic cervical length measurement at term in the prediction of successful induction of labour (IOL). Materials and Methods This prospective study was carried out in the Department of Obstetrics and Gynaecology of Federal Teaching Hospital Abakaliki between 1st of July and 30th of November 2015. Preinduction Bishop score and cervical length were assessed before induction of labour. Intracervical, cervical, extraamniotic Foley catheter was used to improve the Bishop score. The data were analyzed using the IBM SPSS Statistics 20. Results The mean maternal age of the study group was 30.68 ± 6.38 years with a range of 19–43 years. The mean gestational age and parity were 39.57 ± 1.49 and 1.85 ± 0.63, respectively. All the women studied had successful induction of labour with mean induction delivery time of 8.1 ± 3.0 hours and mean duration of labour of 7.4 ± 2.9 hours. Preinduction cervical length is a good predictor of a short duration of labour (P = 0.001). Parturient with a preinduction cervical length of less than 3 cm was likely to have labour lasting less than 6 hours (RR = 4.20 (95% CI 1.85–9.529). Conclusion Transvaginal sonographic measurement of cervical length provides a useful prediction of the likelihood of duration of labour following the induction of labour. It is recommended that IOL should be considered and success anticipated in a parturient with a cervical length less than 3 cm.

Transvaginal ultrasonographic measurement of cervical length in asymptomatic high‐risk women with a short cervical length in the previous pregnancy

To determine if asymptomatic women at high risk of preterm delivery who had a short cervical length in their previous pregnancy and delivered at term are at increased risk of having a short cervical length in their next pregnancy, and whether they are at increased risk of preterm birth. This retrospective cohort study included high-risk (those with a history of spontaneous preterm birth, uterine anomaly or excisional treatment for cervical dysplasia) asymptomatic women who were pregnant with a singleton gestation delivering between April 2003 and March 2010, who had had a previous pregnancy and who had transvaginal ultrasonographic cervical length measurement performed at 16-30 weeks' gestation in both pregnancies. Comparison was among women who had a short cervical length (< 3.0 cm) in their previous pregnancy but delivered at term in that pregnancy (Short Term Group), women with a history of a normal cervical length (≥ 3.0 cm) in their previous pregnancy delivering at term (Long Term Group), and women who had a short cervical length (< 3.0 cm) in their previous pregnancy delivering preterm (Short Preterm Group). Primary outcomes were spontaneous preterm birth at < 37 weeks' gestation and cervical length. Secondary outcomes were spontaneous preterm birth at < 35 weeks and < 32 weeks, low birth weight, maternal outcomes and neonatal morbidity. A total of 62 women were included. Women in the Short Term Group were more likely to have a short cervical length in their next pregnancy compared with those in the Long Term Group (10/23 (43.5%) vs. 4/26 (15.4%), respectively) but not as likely as women in the Short Preterm Group (9/13 (69.2%); P=0.003). Women in the Short Term Group were not at an increased risk of spontaneous preterm birth at < 37 weeks in the next pregnancy compared with women in the Long Term Group (2/23 (8.7%) vs. 2/26 (7.7%), respectively), but women in the Short Preterm Group were at an increased risk (6/13 (46.2%); P<0.0001). Compared with women in the Short Term and Long Term groups, women in the Short Preterm Group were also at an increased risk of threatened preterm labor (6/23 (26.1%) and 4/26 (15.4%) vs. 9/13 (69.2%), respectively; P=0.002) and of receiving corticosteroids for fetal lung maturation (6/23 (26.1%) and 4/26 (15.4%) vs. 11/13 (84.6%), respectively; P<0.0001). Although high-risk asymptomatic women with a short cervical length in their previous pregnancy who delivered at term are at increased risk of having a short cervix in their next pregnancy, they are not at increased risk of preterm birth.

Ultrasonographic measurement of cervical length in predicting mode of delivery after oxytocin induction

This study was conducted to explore the value of transvaginal ultrasonographic cervical length measurement, in addition to gestational age, maternal age, parity, Bishop score, and weight of the newborn, in predicting the mode of delivery in pregnancies in which labor is induced with oxytocin at or beyond the 40th gestational week. A total of 73 pregnancies at 40 to 42 weeks of gestation were included. After labor was induced, 29 women delivered vaginally and 44 underwent cesarean section. These groups were compared with respect to possible predictive parameters of delivery outcomes. Student t test, Pearson's correlation analysis, and logistic regression analysis were used for statistical evaluation. Mean preinduction cervical length was 26.8+/-9.9 mm in the vaginal delivery group and 34.2+/-8.1 mm in the cesarean section group (P<.05). Mean maternal age, parity, and Bishop score were significantly higher and mean weight of the newborn was significantly lower in the vaginal delivery group. Cervical length measurements showed a significant negative correlation with Bishop scores (r=-.584; P<.05). Logistic regression analysis revealed that Bishop score (likelihood ratio=.472; 95% confidence interval=.338-.658; P<.05) and weight of the newborn (likelihood ratio=1.002; 95% confidence interval=1.00007-1.003; P<.05) were significant independent predictors of the route of delivery. According to the results of this study, maternal age, parity, Bishop score, cervical length, and weight of the newborn all might affect the mode of delivery after labor induction. Bishop score, although a subjective measure, must be considered an important component of preinduction evaluation.

Transvaginal ultrasonographic cervical length measurement as a predictor of successful labor induction

transvaginal ultrasonographic cervical length measurement as a predictor of successful labor induction

Accuracy of cervical transvaginal ultrasonography in predicting preterm birth: a systematic review

To determine the accuracy with which transvaginal cervical ultrasonography predicts spontaneous preterm birth, studies were identified, without language restrictions, through nine different databases (1966–2002) and manual searching of bibliographies of known primary and review articles. Studies were selected if they undertook transvaginal ultrasonographic cervical length measurement among a population of pregnant women antenatally and had known gestation at delivery. Data were extracted for studies’ characteristics, quality and accuracy results for < 32, < 34 and < 37 weeks’ gestation outcome as the reference standards. Data were stratified according to singletons or twins, gestational age at testing, cervical length thresholds and the various reference standards. Data were pooled to produce summary estimates of likelihood ratios (LRs). Forty-six primary articles included a total of 31 577 women, consisting of 33 studies in asymptomatic and 13 studies in symptomatic women. There was a wide variation among studies with respect to gestational age at testing, definition of threshold for abnormality and definition of reference standard. The most commonly reported subgroup was testing of asymptomatic women at 20–24 weeks’ gestation using a threshold of 25 mm with spontaneous preterm birth before 34 weeks’ gestation as the reference standard. The summary LR+ for this group was 4.44 (95% confidence interval (CI) 3.23–6.08), with corresponding LR− of 0.68 (95% CI 0.49–0.94).

Effect of cerclage on obstetrical outcome in twin gestations with a shortened cervical length

Objective: Our purpose was to determine the impact of cerclage placement on obstetric outcome in twin gestations with a shortened cervical length. Study design: A prospective cohort study of 147 consecutive twin pregnancies (July 1994 to March 2001) who underwent transvaginal ultrasonographic cervical length measurement between 18 and 26 weeks' gestation. Cerclage was offered to women with cervical lengths ≤25 mm. Patients were segregated into quartiles by cervical length. Regression analysis and χ2 tests were used to determine the effect of cervical length and cerclage on parameters of prematurity. Results: One hundred twenty-eight twin gestations met inclusion criteria, including 21 (16.4%) who underwent cerclage for a cervical length ≤25 mm. Decreasing cervical length was significantly associated with a shorter length of gestation, lower combined birth weight, delivery at ≤34 weeks, preterm premature rupture of fetal membranes, and very low birth weight. None of these outcomes was altered by cerclage placement. Conclusion: Midtrimester cerclage does not alter the risks of prematurity associated with a shortened cervical length in twin gestations. (Am J Obstet Gynecol 2002;186:634-40.)