Cervical Assessment by Ultrasound for Predicting Preterm Birth
Objective: The determine the diagnostic accuracy of measurement of cervical length using transvaginal ultrasound in women at risk of preterm delivery.
Methods: This was study was carried out in the department of Radiology and Obstetrics and Gynecology, during a period of six months from November 2021 to April 2022. Total 133 women were recruited in this study as per inclusion and exclusion criteria. Each patient underwent general examination, abdominal examination, routine investigations and ultrasound scan for gestational age assessment and to rule out any possible abnormality. Cervical length measurements were done at presentation to the labor ward, after four hours. These measurements were done via the TVUS method and were performed by designated sonographers who had extensive experience. The participants were treated and followed up until delivery according to the hospital’s protocol. Statistical package for social sconces was used for data entry and analysis. Odds ratio and diagnostic accuracy was calculated for cervical length to predict preterm birth.
Results: In preterm group significantly higher number of women had cervical length <3 as compared to women who had term birth. i.e. 85.5% vs. 26.8%, p-value<0.001 & Odds ratio=16.11 (95% CI: 6.68-38.87). Odds ration showed that women with cervical length <3 had 16.11 times higher chances of preterm birth. Sensitivity, Specificity, Positive predictive, Negative predictive and diagnostic accuracy of cervical length <3 was 85.48%, 73.24%, 73.16%, 85.25% and 78.95% respectively.
Conclusion: Based on results of this study it can be concluded that assessment of cervical length with trans vaginal ultrasonography can be used as a diagnostic tool for female presetting with threatened preterm labor.
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