Abstract
Objective: Our purpose was to assess the accuracy of cervical mensuration (length, wedging)
by transvaginal ultrasonography in the prediction of preterm birth among hospitalised
women undergoing preterm labour. Method: Evidence was extracted from articles through a MEDLINE search from 1987 to 1997,
followed up by examining the references at the end of pertinent articles.The key words
were: pregnancy, cervix, ultrasonography, preterm labour, preterm delivery, cervical
length, cervical wedging or funnelling. Final criteria for the selection of the studies
were cervical length and/or wedging at internal os in hospitalised women undergoing
preterm labour without restriction on the study design. Results: Nine articles from 12 publications were analysed and incorporated in a discussion.
Study design and selection criteria vary among publications. Preterm delivery was
the principal outcome, but its definition is not the same according to the authors.
The best cut-off for cervical length varies from 18 to 30 mm. The size of the samples
is limited. The sensitivity for predicting preterm birth ranges from 68 to 100%, and
the specificity ranges from 30 to 78%. Cervical wedging has a sensitivity varying
from 23 to 100%, and a specificity ranging from 54 to 90%. Conclusion: Ultrasonography of the cervix is an interesting technology as it is cheap and easy
to use. However this technique remains to be assessed before implementing it in daily
clinical practice. Finally, studies incorporating transvaginal ultrasonography into
interventional trials are needed to determine the efficacy of measuring cervical length
in the prevention of preterm birth.
Keywords
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Article info
Publication history
Accepted:
July 7,
1999
Received:
February 10,
1999
Identification
Copyright
© 2000 Elsevier Science Ireland Ltd. Published by Elsevier Inc. All rights reserved.
