Transvaginal Ultrasonographic Evaluation of the Uterine Cervix in Preterm Labor

Yang, H G; Lee, H H; Lee, J J; Lee, M H; Koo, D H; Jeon, S; Choi, G H; Lee, H J; Shin, J O; Lee, I S; Lee, K H

Abstract

OBJECTIVE
Our purpose was to test the hypothesis that characteristics of the cervix evaluated by transvaginal ultrasonography are associated with preterm labor and preterm delivery.
METHODS
Fifty-one patients with preterm labor of singleton pregnancy admitted to the hospital were evaluated by transvaginal ultrasonography before institution of treatment. Preterm delivery was defined as any delivery before 37 weeks of gestation. The ultrasonographic parameters evaluated were cervical length and presence of wedging. Data analysis was performed by the student t test and chi-square test. The p value < 0.05 was considered significant.
RESULTS
The presence of cervical wedging and shorter cervical length were significantly associated with preterm delivery[p<0.001]. The presence of cervical wedging in the prediction of preterm delivery in this data set yielded a sensitivity of 100%, a specificity of 81.6%, a positive predictive value of 65%, and a negative predictive value of 100%. The cervical length < OR = 29mm in the prediction of preterm delivery in this data set yielded a sensitivity of 100%, a specificity of 89.5%, a positive predictive value of 76.2%, and a negative predictive value of 100%.
CONCLUSION
The presence of cervical wedging and shorter cervical length in patients with preterm labor measured by transvaginal ultrasonography are useful as a predictor of preterm delivery.