CERVICAL LENGTH ASSESSMENT DURING PREGNANCY USING ULTRASOUND MEASURES IN DUHOK CITY

  • DILGASH HAMEED AHMAD College of Medicine, University of Duhok, Kurdistan Region-Iraq
  • SOHAIB HASAN ALI College of Medicine, University of Duhok, Kurdistan Region-Iraq
  • MAYSALOON SHAMAN SAEED College of Medicine, University of Duhok, Kurdistan Region-Iraq
Keywords: Cervical length measurement , gestational age , Ultrasound ,Transabdominal , Transvaginal.

Abstract

Preterm birth has been regarded as a major cause of perinatal morbidity and mortality with an incidence ranging from 5-18 % worldwide. Early screening of pregnant women at risk of preterm delivery and managing it correctly are essential aids to reduce the predictable complications associated with prematurity

Objective: The main aim of the study was to assess the true and acuurate cervical measuremants that predict the clear definition and cut values of the cervical incompetence in second trimester pregnant women by using transabdominal and transvaginal Ultrasound .

More specofc aim of the study was looking for the accuracy of transabdominal ultrasound in measuring the cervical length for prediction of preterm birth when compared with transvaginal ultrasound, assessment of the mean cervical lengthin the second trimester pregnancy , the correlation between both of these modalities in each case , finding the clear cut off value of transabdominal Ultrasound measurement to be further assessed by transvaginal Ultrasound .

Materials: A cross sectional prospective study done on ninety-three pregnant women between 12-22 weeks of gestation who were referred between March to November of 2018in thisprospective study ,their cervical lengths were assessed by using transabdominal Ultrasound , using Transvaginal Ultrasound as the reference, both methods were correlated forvariance.

Results: The mean transabdominal cervical length measurements was seen to range (34.3 ± 5.8 mm) while the mean transabdominal cervical length measurements was seen to range (35.9 ± 4.4 mm). The mean transabdominal cervical length was shorter than the mean transvaginal cervical length by an average of 1.6 mm. The 10th percentile of transabdominal and transvaginal cervical length was 27 mm and29.4 mm, respectively. The two groups that showed significant difference between the two scanning methods were the 25th-50th centile group (TACL) of 33-37 mm) with p = 0.019, and the 50th-75th centile group (TACL) of 37-40 mm) with p =0.001 , the clear cut value of 27 mm was the value considered to revert fron TAUS to TVUS for CL assessment

Conclusion:TAUS was found to be an initial CL screening method in the second trimester pregnant women generally while from 12- 14 weeks GA specifically the TVUS is preferred for this measurement ,a cut-off value of 27 mm is used to revert to TVUS for CL assessment instead of TAUS.

 

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References

Blencowe, H., Cousens, S., Oestergaard, M., Chou, D., Moller, A., Narwal, R., Adler, A., Vera Garcia, C., Rohde, S., Say, L. and Lawn, J. (2012). National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. The Lancet; 379(9832),pp.2162-2172.
Cetingoz, E., Da Fonseca, E., Creasy, G., Klein, K., Rode, L., Soma-Pillay, P., Fusey, S., Cam, C., Alfirevic, Z. and Hassan, S. (2012). Vaginal progesterone in women with an asymptomatic sonographic short cervix in the midtrimester decreases preterm delivery and neonatal morbidity: a systematic review andmetaanalysis of individual patient data.American Journal
ofObstetrics and Gynecology, 206;pp.124.e1- 124.e19.
Hassan, S., Romero, R., Hendler, I., Gomez, R., Khalek, N., Espinoza, J., Kae Nien, J., M. Berry, S., Bujold, E., Camacho, N. and Sorokin, Y. (2000). A sonographic short cervix as the only clinical manifestation of intra-amniotic infection. Journal of Perinatal Medicine, 34;pp.9-13.
Hernandez-Andrade, E., Romero, R., Ahn, H., Hussein, Y., Yeo, L., Iams, J., Goldenberg, R., Meis, P., Mercer, B., Moawad, A., Das, A., Thom, E., McNellis, D., Copper, R., Johnson, F. and Roberts, J. (1996). The Length of the Cervix and the Risk of Spontaneous Premature Delivery. New England Journal of Medicine, 334; pp.567-573.
Iams, J., Goldenberg, R., Meis, P., Mercer, B., Moawad, A., Das, A., Thom, E., McNellis, D., Copper, R., Johnson, F. and Roberts, J. (1996). The Length of the Cervix and the Risk of Spontaneous Premature Delivery. New England Journal of Medicine, 334; pp.567-573.
Korzeniewski, S., Chaiworapongsa, T. and Hassan, S. (2012). Transabdominal evaluation of uterine cervical length during pregnancy fails to identify a substantial number of women with a short cervix. The Journal of Maternal-Fetal & Neonatal Medicine, 25; pp.1682-1689. ,
Kurjak, A. (2000). Ultrasound scanning – Prof. Ian Donald (1910– 1987). European Journal of Obstetrics & Gynecology and Reproductive Biology, 90; pp.187-189.
Moroz, L. and Simhan, H. (2012). Rate of sonographic cervical shortening and the risk of spontaneous preterm birth. American Journal of Obstetrics and Gynecology, 206; pp.234.e1- 234.e5.
Nambiar, J., Pai, M., Reddy, A. and Kumar, P. (2017). Can Transabdominal Scan Predict a Short Cervix by Transvaginal Scan?. Obstetrics and Gynecology International, 2017; pp.1-3.
O'Hara, S., Zelesco, M. and Sun, Z. (2013). Cervical length for predicting preterm birth and a comparison of ultrasonic measurement techniques. Australasian Journal of Ultrasound in Medicine, 16; pp.124-134.
Peng, C., Chen, C., Wang, K., Wang, L., Chen, C. and Chen, Y. (2015). The reliability of transabdominal cervical length measurement in a low-risk obstetric population: Comparison with transvaginal measurement. Taiwanese Journal of Obstetrics and Gynecology, 54;pp.167-171.
Roh, H., Ji, Y., Jung, C., Jeon, G., Chun, S. and Cho, H. (2014). Comparison of Cervical Lengths Using Transabdominal and Transvaginal Sonography in Midpregnancy. Obstetrical & Gynecological Survey, 69;pp.126-128.
Romero, R., Nicolaides, K., Conde-Agudelo, A., Tabor, A., O'Brien, J.,Cetingoz, E., Da Fonseca, E., Creasy, G., Klein, K., Rode, L., Soma-Pillay, P., Fusey, S., Cam, C., Alfirevic, Z. and Hassan, S. (2012). Vaginal progesterone in women with an asymptomatic sonographic short cervix in the midtrimester decreases preterm delivery and neonatal morbidity: a systematic review andmetaanalysis of individual patientdata.AmericanJournal of Obstetrics and Gynecology,
206; pp.124.e1- 124.e19.
Rumack, C., Wilson, S., Charboneau, W. and Levine, D.(2011). Diagnostic ultrasound. 4th ed. St. Louis: Elsevier Mosby; pp.1527-1539.
Stone, P., Chan, E., Mccowan, L., Taylor, R. and Mitchell, J. (2010). Transabdominal scanning of the cervix at the 20-week morphology scan: Comparison with transvaginal cervical measurements in a healthy nulliparous population. Australian and New Zealand Journal of Obstetrics and Gynaecology, 50; pp.523-527.
Published
2021-12-23
How to Cite
AHMAD, D. H., ALI, S. H., & SAEED, M. S. (2021). CERVICAL LENGTH ASSESSMENT DURING PREGNANCY USING ULTRASOUND MEASURES IN DUHOK CITY. Journal of Duhok University, 24(2), 136-145. Retrieved from https://journal.uod.ac/index.php/uodjournal/article/view/1400
Section
Pure and Engineering Sciences