Korean J Perinatol.  2013 Jun;24(2):82-88. 10.14734/kjp.2013.24.2.82.

Significance of Gray-Level Histogram of the Uterine Cervix as a Predictor of Preterm Birth in Pregnant Women with Preterm Labor

• Kim YH
• Kim JW
• Lee HJ
• Kim JW
• Moon JH
• Song TB

• KMID: 2280924
• DOI: http://doi.org/10.14734/kjp.2013.24.2.82

Abstract

PURPOSE
The aim of this study was to determine the value of a gray-level histogram of the cervix as a predictor of preterm birth in women who admitted for preterm labor.
METHODS
Ninety-seven women who admitted Chonnam national university for preterm labor were enrolled in this prospective study. A transvaginal ultrasonography for measurement of cervical length (CL), gray-scale histogram and cervical volume was performed when patients were admitted. Anterior and posterior cervical walls and AP (anterior and posterior) difference in MGL (mean gray level between anterior and posterior) were checked. And we analyzed the relationship between the value and preterm birth.
RESULTS
The overall rate of preterm birth before 37 weeks was 53.6% and after 37 weeks was 46.4%, respectively. Logistic regression analysis demonstrated that not only cervix length (P=0.003; odds ratio [OR], 0.189; 95% confidence interval [CI], 0.064-0.560) but also anterior histogram (P=0.028; OR, 0.319; 95% CI, 0.115-0.884) was independent predictor of preterm birth before 37 weeks. The receiver operator characteristics (ROC) curves were analyzed for the anterior histogram, a value of 85.9 was the best cut-off value to determine the preterm birth. The areas under the ROC curve indicate that the variable provides a prognostic value for the prediction for preterm birth. To predict a preterm birth, anterior histogram had 78.8% sensitivity and 46.7% specificity.
CONCLUSION
Gray-level histogram of the uterine cervix may predict the preterm birth in pregnant women with preterm labor.

Keyword

Gray-scale histogram; Preterm birth; Uterine cervix length; Predictor

MeSH Terms

Cervix Uteri
Female
Humans
Logistic Models
Obstetric Labor, Premature
Odds Ratio
Pregnancy
Pregnant Women
Premature Birth
Prospective Studies
ROC Curve

Figure

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  Fig. 1 Ultrasonographic assessment of the uterine cervix. (A) Cervix length, (B) Histogram (anterior lip), (C) Histogram (posterior lip).

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  Fig. 2 Cervix volume by 3-D sonography using extended imaging virtual organ computer-aided analysis (XI VOCAL) technique.

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  Fig. 3 Receiver operating characteristic curve for anterior lip histogram value in predicting preterm birth. The cutoff value is 85.9 (Area under the curve 0.634; Cl, 0.522-0.747; P=0.023). Abbreviation: CxAmean, Cervix anterior lip histogram mean value.

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