It is about time. The advantage of transabdominal cervical length screening

Abstract

Purpose

Sonographic cervical length (CL) measurement has become a standard practice for identifying women at increased risk for preterm birth. We aimed to assess the time needed for CL measurement during fetal anatomy scan using either transabdominal or transvaginal ultrasound, and to provide a predictive value of the transabdominal CL measurements for reassuring transvaginal CL measurements of more than 25 mm.

Methods

In a prospective study we measured CL transabdominally, and transvaginally in all the anatomy scans performed at 18–25 weeks’ gestation, from January 2017 until January 2018. CL and the duration of the examination were compared between the two approaches. Adjustments were made for, body mass index, previous cesarean sections and parity.

Results

Four hundred sixty-eight patients participated in the study. The time needed for the transabdominal CL measurement was significantly lower compare with the transvaginal CL measurement (0.46 ± 0.3 min versus 6.9 ± 1.38 min, p < 0.001). The CL measured transabdominally was significantly shorter than the CL measured transvaginally (36.7 ± 6.7 mm versus 41.9 ± 7.3 mm, respectively p < 0.001). All women with transabdominal CL measurements above 36 mm (64.2% of patients) had a transvaginal CL of more than 25 mm.

Conclusion

Transvaginal measurement of CL is a time-consuming procedure that prolong fetal anomaly scan by 25%. Transabdominal CL measurement of 36 mm is reassuring CL above 25 mm. Transabdominal ultrasound should be used as an initial tool for CL screening. Transvaginal measurements of CL should be reserved for high-risk women, for women with difficulties in demonstrating the cervix abdominally, and for women with transabdominal measurements of less than 36 mm.

Keywords:

• Cervical length screening
• preterm birth
• transabdominal ultrasound
• transvaginal ultrasound

Acknowledgment

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

All authors contributed to the study conception and design, read, and approved the final manuscript.

Y. Ginsberg – Protocol development, data management & analysis, manuscript writing.

Y. Zipori – Data collection, data analysis, manuscript writing.

N. Khatib – Protocol development, data analysis.

D. Schwake – Data collection.

I. Goldstein – Manuscript editing.

A. Shrim – Data collection.

Z. Weiner – Manuscript editing.

R. Beloosesky – Protocol development, manuscript editing.