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P14Sonographic features of the cervix in the midtrimester as a predictor of preterm delivery
Author(s) -
Fukami T.,
Sekiya T.,
Yoshimatsu K.,
Otabe T.,
Tsukada K.,
Ishihara K.,
Araki T.
Publication year - 2000
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.2000.00004-1-14.x
Subject(s) - medicine , gestation , cervix , gestational age , obstetrics , predictive value , preterm delivery , pregnancy , gynecology , prospective cohort study , ultrasound , predictive value of tests , radiology , surgery , cancer , genetics , biology
Background The purpose of this study was to predict preterm delivery by transvaginal ultrasound in the midtrimester. Method This prospective study was conducted on 568 outpatients with normal pregnancy up to 16 gestational weeks. After the patient's consent was obtained, serial transvaginal ultrasound scanning (TVS) was planned at 2–4 weekly intervals from 16 to 27 gestational weeks, and used to assess cervical length, cervical gland area and internal os dilatation. Results (1) The preterm delivery (37 weeks gestation) rate of the patients was 3.0% (17/568). (2) Of the three predictive factors of preterm delivery namely shortened cervical length (30 mm), absence of cervical gland area, and internal os dilatation, the most useful monographic feature of the cervix was absence of cervical gland area examined at 16–19 weeks gestation. (3) The combination of these factors at 16–19 weeks gestation improved the predictive value (sensitivity 35%, specificity 99%, positive predictive value 88%, negative predictive value 96%). Conclusion For the prediction of preterm delivery by TVS in the midtrimester, the most appropriate gestational period was at 16–19 weeks, and the best predictive factor was a combination of the absence of cervical gland area with shortened cervix and internal osdilatation.