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Significance of ultrasound vaginal cervicometry in predicting preterm delivery
Michal Mára1, Pavel Calda, Lucie Haaková
1Department of Obstetrics and Gynecology, 1st Faculty of Medicine, Charles University and the General Faculty Hospital, Prague, Czech Republic. michal.mara@quick.cz
Background:
The objective of the study was to verify whether ultrasound vaginal cervicometry, performed in the 18th-20th week of gestation, can effectively predict preterm delivery.
Material/Methods:
279 singleton pregnancies were prospectively studied from the middle of gestation until delivery. In the 18th-20th week of gestation we performed ultrasound vaginal cervicometry, which we used to determine the length of the cervix, judge the shape of the internal os, and evaluate the cervicometry as normal or abnormal on the basis of these parameters. With the aid of one-dimensional and multi-dimensional analysis, we tested the dependence of completed weeks of gestation and preterm delivery on the results of ultrasound cervicometry.
Results:
247 women completed the study. Cervicometry was evaluated as abnormal in 53 women (21.46%). We proved a significant dependence of delivery prior to the 34th week of gestation on cervical length (p<0.01), abnormal shape of the internal os (p<0.0001; RR=10.35), and abnormal cervicometric result (p<0.0001; RR=29.28). Delivery prior to the 37th week was also significantly dependent on all observed parameters. Of the individual cervicometric parameters, cervical length had the most significant impact on the completed weeks of gestation.
Conclusions:
The implementation of ultrasound vaginal cervicometry in the prenatal screening program can lead to effective and early selection of women with a significantly increased risk of preterm delivery.