Cervical Assessment by Ultrasound for Predicting Preterm Birth

Abstract

Objective: To determine the diagnostic accuracy of measurement of cervical length using transvaginal ultrasound in women at risk of preterm delivery.

Methodology: This study was conducted in the department of Radiology and Obstetrics and Gynecology from June 2021 to December 2021. Total 133 women were recruited in this study as per inclusion and exclusion criteria. Each patient underwent a general examination, abdominal examination, routine investigations, and ultrasound scan for gestational age assessment and to rule out any possible abnormalities. After cervical length measurements were done at presentation to the labor ward, after four hours. These measurements were made 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. A statistical package for social sciences was used for data entry and analysis. The odds ratio and diagnostic accuracy was calculated for cervical length to predict preterm birth.  

Results: In preterm group, a 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). The odds ratio 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 the results of this study, it can be concluded that the assessment of cervical length with transvaginal ultrasonography can be used as a diagnostic tool for female presetting with threatened preterm labor.