Transvaginal ultrasonographic cervical assessment for the prediction of preterm delivery

Isao Hasegawa Department of Obstetrics and Gynecology, Niigata University School of Medicine (I. H., Ke.T.), Sendai National Hospital (Ka.T.), National Ookura Hospital (Ta.T.), Nagoya City, Niigata, Japan; University (K.A.), Seirei Hamamatsu Hospital (Y.T.), Tokyo University Faculty of Medicine (T.O.), Osaka University Faculty of Medicine (F.S.), Yokohama City Hospital (Ts.T.), Toranomon Hospital (K.S.), Department of Pediatrics, Osaka Maternal Fetal Medical Center (M.F.), Saitama Medical Collage (Y. O.), Niigata, Japan

Kenichi Tanaka Department of Obstetrics and Gynecology, Niigata University School of Medicine (I. H., Ke.T.), Sendai National Hospital (Ka.T.), National Ookura Hospital (Ta.T.), Nagoya City, Niigata, Japan; University (K.A.), Seirei Hamamatsu Hospital (Y.T.), Tokyo University Faculty of Medicine (T.O.), Osaka University Faculty of Medicine (F.S.), Yokohama City Hospital (Ts.T.), Toranomon Hospital (K.S.), Department of Pediatrics, Osaka Maternal Fetal Medical Center (M.F.), Saitama Medical Collage (Y. O.), Niigata, Japan

Katsuyuki Takahashi Department of Obstetrics and Gynecology, Niigata University School of Medicine (I. H., Ke.T.), Sendai National Hospital (Ka.T.), National Ookura Hospital (Ta.T.), Nagoya City, Niigata, Japan; University (K.A.), Seirei Hamamatsu Hospital (Y.T.), Tokyo University Faculty of Medicine (T.O.), Osaka University Faculty of Medicine (F.S.), Yokohama City Hospital (Ts.T.), Toranomon Hospital (K.S.), Department of Pediatrics, Osaka Maternal Fetal Medical Center (M.F.), Saitama Medical Collage (Y. O.), Niigata, Japan

Tadao Tanaka Department of Obstetrics and Gynecology, Niigata University School of Medicine (I. H., Ke.T.), Sendai National Hospital (Ka.T.), National Ookura Hospital (Ta.T.), Nagoya City, Niigata, Japan; University (K.A.), Seirei Hamamatsu Hospital (Y.T.), Tokyo University Faculty of Medicine (T.O.), Osaka University Faculty of Medicine (F.S.), Yokohama City Hospital (Ts.T.), Toranomon Hospital (K.S.), Department of Pediatrics, Osaka Maternal Fetal Medical Center (M.F.), Saitama Medical Collage (Y. O.), Niigata, Japan

Koji Aoki Department of Obstetrics and Gynecology, Niigata University School of Medicine (I. H., Ke.T.), Sendai National Hospital (Ka.T.), National Ookura Hospital (Ta.T.), Nagoya City, Niigata, Japan; University (K.A.), Seirei Hamamatsu Hospital (Y.T.), Tokyo University Faculty of Medicine (T.O.), Osaka University Faculty of Medicine (F.S.), Yokohama City Hospital (Ts.T.), Toranomon Hospital (K.S.), Department of Pediatrics, Osaka Maternal Fetal Medical Center (M.F.), Saitama Medical Collage (Y. O.), Niigata, Japan

Yuichi Torii Department of Obstetrics and Gynecology, Niigata University School of Medicine (I. H., Ke.T.), Sendai National Hospital (Ka.T.), National Ookura Hospital (Ta.T.), Nagoya City, Niigata, Japan; University (K.A.), Seirei Hamamatsu Hospital (Y.T.), Tokyo University Faculty of Medicine (T.O.), Osaka University Faculty of Medicine (F.S.), Yokohama City Hospital (Ts.T.), Toranomon Hospital (K.S.), Department of Pediatrics, Osaka Maternal Fetal Medical Center (M.F.), Saitama Medical Collage (Y. O.), Niigata, Japan

Takashi Okai Department of Obstetrics and Gynecology, Niigata University School of Medicine (I. H., Ke.T.), Sendai National Hospital (Ka.T.), National Ookura Hospital (Ta.T.), Nagoya City, Niigata, Japan; University (K.A.), Seirei Hamamatsu Hospital (Y.T.), Tokyo University Faculty of Medicine (T.O.), Osaka University Faculty of Medicine (F.S.), Yokohama City Hospital (Ts.T.), Toranomon Hospital (K.S.), Department of Pediatrics, Osaka Maternal Fetal Medical Center (M.F.), Saitama Medical Collage (Y. O.), Niigata, Japan

Fumitaka Saji Department of Obstetrics and Gynecology, Niigata University School of Medicine (I. H., Ke.T.), Sendai National Hospital (Ka.T.), National Ookura Hospital (Ta.T.), Nagoya City, Niigata, Japan; University (K.A.), Seirei Hamamatsu Hospital (Y.T.), Tokyo University Faculty of Medicine (T.O.), Osaka University Faculty of Medicine (F.S.), Yokohama City Hospital (Ts.T.), Toranomon Hospital (K.S.), Department of Pediatrics, Osaka Maternal Fetal Medical Center (M.F.), Saitama Medical Collage (Y. O.), Niigata, Japan

Tsuneo Takahashi Department of Obstetrics and Gynecology, Niigata University School of Medicine (I. H., Ke.T.), Sendai National Hospital (Ka.T.), National Ookura Hospital (Ta.T.), Nagoya City, Niigata, Japan; University (K.A.), Seirei Hamamatsu Hospital (Y.T.), Tokyo University Faculty of Medicine (T.O.), Osaka University Faculty of Medicine (F.S.), Yokohama City Hospital (Ts.T.), Toranomon Hospital (K.S.), Department of Pediatrics, Osaka Maternal Fetal Medical Center (M.F.), Saitama Medical Collage (Y. O.), Niigata, Japan

Kodo Sato Department of Obstetrics and Gynecology, Niigata University School of Medicine (I. H., Ke.T.), Sendai National Hospital (Ka.T.), National Ookura Hospital (Ta.T.), Nagoya City, Niigata, Japan; University (K.A.), Seirei Hamamatsu Hospital (Y.T.), Tokyo University Faculty of Medicine (T.O.), Osaka University Faculty of Medicine (F.S.), Yokohama City Hospital (Ts.T.), Toranomon Hospital (K.S.), Department of Pediatrics, Osaka Maternal Fetal Medical Center (M.F.), Saitama Medical Collage (Y. O.), Niigata, Japan

Masatetsu Fujimura Department of Obstetrics and Gynecology, Niigata University School of Medicine (I. H., Ke.T.), Sendai National Hospital (Ka.T.), National Ookura Hospital (Ta.T.), Nagoya City, Niigata, Japan; University (K.A.), Seirei Hamamatsu Hospital (Y.T.), Tokyo University Faculty of Medicine (T.O.), Osaka University Faculty of Medicine (F.S.), Yokohama City Hospital (Ts.T.), Toranomon Hospital (K.S.), Department of Pediatrics, Osaka Maternal Fetal Medical Center (M.F.), Saitama Medical Collage (Y. O.), Niigata, Japan

Yunosuke Ogawa Department of Obstetrics and Gynecology, Niigata University School of Medicine (I. H., Ke.T.), Sendai National Hospital (Ka.T.), National Ookura Hospital (Ta.T.), Nagoya City, Niigata, Japan; University (K.A.), Seirei Hamamatsu Hospital (Y.T.), Tokyo University Faculty of Medicine (T.O.), Osaka University Faculty of Medicine (F.S.), Yokohama City Hospital (Ts.T.), Toranomon Hospital (K.S.), Department of Pediatrics, Osaka Maternal Fetal Medical Center (M.F.), Saitama Medical Collage (Y. O.), Niigata, Japan

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Abstract

To determine the usefulness of transvaginal ultrasonographic cervical assessment for the prediction of preterm delivery in an apparently normal population, 729 pregnant women (between 15 and 34 weeks' gestation) were randomly enrolled in the study in ten tertiary perinatal centers in Japan. Cervical parameters, including cervical length, internal os dilatation, and funneling depth, were measured by transvaginal ultrasound. The predictive values of these measurements for preterm delivery were investigated in a prospective fashion. Among various cervical parameters, cervical length showed the best correlation with pregnancy outcome. Cervical length (mm) was gradually decreased as the gestational age progressed, the regression line being y = 41.21 – 0.22x. When the mean cervical length minus 1 standard deviation at each gestational age was chosen as a cut-off value, the group with a shortened cervix showed a significantly high preterm delivery rate exclusively in the primigravidae (odds ratio: 4.86, 95% CI: 1.85–12.72). Internal os dilatation, in contrast, was a useful predictor in multiparous women (odds ratio: 6.00, 95% CI: 1.65–21.71). It was concluded that tranvaginal ultrasonographic cervical assessment, especially the measurement of cervical length, was effective for the prediction of preterm delivery in the primigravidae.

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Transvaginal ultrasonographic cervical assessment for the prediction of preterm delivery

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Transvaginal ultrasonographic cervical assessment for the prediction of preterm delivery

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