engleski

Cervical length and qualitative cervical index measured by transvaginal sonograpy as potential screening test for preterm delivery. Preliminary results in low risk population.

OBJECTIVE: Comparison of cervical length (CL) and Qualitative Cervical Index (QCI) measured by transvaginal sonography (TVS) in mid trimester regarding the prediction of preterm delivery (PTD) in low risk population. STUDY DESIGN: In this prospective study 146 low risk, asymptomatic, nulliparous pregnant women with singleton pregnancies had TVS measurement of the cervix in mid trimester (16 &#8211; 23 weeks). An adequate sonographic image was defined as, the visualization of endocervical canal with the presence of internal and external cervical axis. On the sonographic image, CL and QCI were evaluated. CL < 28 mm (< 10th percentile) was defined as shortened. The parameters evaluated in QCI were: cervical mucus area (CMA) (0 &#8211; absent CMA, 1 &#8211; CMA < 20mm2, 2 &#8211; CMA > 20mm2) and thickness of cervical gland area (TCGA) (0 &#8211; absent CGA, 1 &#8211; TCGA < 5 mm, 2 &#8211; TCGA > 5 mm), the value was represented as summary of CMA and TCGA. QCI < 1 (< 10th percentile) was defined as abnormal finding. The objective was to show the potential relationship of CL measurement and QCI in mid trimester regarding the prediction of PTD (< 37 weeks) in low risk population. RESULTS: Shortened CL was found in 11.64% (17/146) whereas the abnormal QCI was found in 8.91% (13/146). The incidence of PTD was 6.8% (10/146). As a potential screening test for PTD, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of QCI were, respectively, 63.5%, 95.5%, 53.8%, and 96.9% and for CL they were 54.5%, 91.8%, 35.2%, and 96.1%. CONCLUSION: QCI had higher sensitivity and PPV in comparison with CL regarding the prediction of preterm delivery in low risk population.

Transvaginal sonography; cervical length; cervical mucus area; cervical gland area; mid trimester; preterm delivery

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