Preterm labor diagnosis by sonographic measurement of the uterine cervical length (original) (raw)
Radiologia Brasileira, 2010
OBJETIVO: Avaliar o comprimento do colo uterino pela ultrassonografia transvaginal em uma população de gestantes normais e construir uma curva de normalidade no período de 20 a 34 semanas de gestação. MATERIAIS E MÉTODOS: Estudo de corte transversal, incluindo 145 gestantes normais, com feto único, vivo, sem enfermidades, entre 20 e 34 semanas de gravidez, examinadas nos serviços de ultrassonografia do Hospital Universitário Júlio Müller e de uma clínica privada. As gestantes foram submetidas a ultrassonografia endovaginal, com registro do comprimento cervical. Critérios de exclusão foram: parto prematuro, rotura prematura pré-termo das membranas, placenta prévia, uso de fármacos tocolíticos e/ou progesterona, cerclagem ou qualquer intervenção cirúrgica prévia no colo. A associação entre o comprimento do colo uterino e a idade gestacional foi examinada por regressão linear. RESULTADOS: O comprimento cervical diminuiu progressivamente em 0,8 mm a cada semana, à medida que a idade ges...
Revista da Associação Médica Brasileira, 2013
fosse transformada em um modo em tempo real foi introduzida e tem sido chamada de ultrassonografia em quarta dimensão (4D), a qual permite o monitoramento contínuo da face fetal e de outras áreas da superfície do feto, como, por exemplo, suas extremidades. Alguns estudos já se ocuparam em avaliar esta nova metodologia na observação do comportamento fetal durante diferentes estágios da gestação, na tentativa de melhor entender as relações entre a maturação do sistema nervoso central do feto e suas implicações em seu padrão de comportamento. No presente artigo, os autores realizam uma revisão sobre o uso atual da ultrassonografia 4D na avaliação do comportamento fetal, discorrendo sobre as perspectivas da técnica em espelhar, por meio da observação de padrões de movimentos e expressões faciais, o desenvolvimento neurológico do feto, destacando as potenciais aplicabilidades dessa tecnologia como nova área de pesquisa em medicina fetal.
Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics, 2021
Preterm birth (PTB) is a major obstetric problem associated with high rates of neonatal morbidity and mortality. The prevalence of PTB has not changed in the last decade; thus, the establishment of a screening test and effective treatment are warranted. Transvaginal ultrasound measurement of the cervical length (TUCL) has been proposed as an effective method to screen pregnant women at a higher risk of experiencing PTB. Objective To evaluate the applicability and usefulness of second-trimester TUCL to predict PTB in a cohort of Portuguese pregnant women. Methods Retrospective cross-sectional cohort study including all singleton pregnant women who performed their second-trimester ultrasound (between weeks 18 and 22 + 6 days) from January 2013 to October 2017 at Centro Hospitalar Universitário São João. Results Our cohort included 4,481 women. The prevalence of spontaneous PTB was of 4.0%, with 0.7% occurring before the 34th week of gestation. The mean TUCL was of 33.8 mm, and percent...
Preterm labor is a regular occurrence in pregnancy; an estimated 15 million babies are born prematurely each year, with the number increasing. This was a prospective study of pregnant women who came to the Maternity Teaching Hospital in Erbil, Kurdistan Province, Iraq, for an outpatient clinic. On a manageable sample of 150 singleton pregnancies. In this study, one hundred fifty singleton asymptomatic pregnancies encountered the inclusion criteria during the study period, 69 primi gravid, 81 multi gravid. The correlation between the cervical length at 20-24 weeks and preterm delivery was moderately poor (r =0.715), and this correlation was highly significant (P < 0.001). In another word, a better correlation was found between preterm delivery and cervical length at 20-24 weeks than at 10-14 weeks in the prediction of preterm delivery. This study also points towards the importance of serial ultrasound scans to detect those who are at higher risk. There was no statistically significant effect of age, parity. Finally, the findings revealed that trans vaginal ultrasound is more accurate at 20-24weeks than 10-14weeks gestation for prediction of preterm labor, it can be used routinely to prevent preterm birth.
Preterm delivery and ultrasound measurement of cervical length in Gran Canaria, Spain
International Journal of Gynecology & Obstetrics, 2010
To study the relationship between cervical length measured by ultrasound and risk of preterm delivery.We measured cervical length in 2351 women between the 18th and 22nd week of pregnancy. Preterm delivery was categorized as before 37 weeks, before 34 weeks, and before 30 weeks.Before the 37th week, the odds ratios (ORs) of spontaneous delivery for cervical lengths in the 3rd, 5th, and 10th percentiles were, respectively, 25.47 (95% confidence intervals [CI], 15.5–41.73); 16.98 (95% CI, 11.51–25.05); and 7.55 (95% CI, 5.44–10.5). Before the 34th week the ORs were 28.7 (95% CI, 14.54–41.73); 20.5 (95% CI, 11.51-25.05); and 10.3 (95% CI, 5.44–10.5). And before the 30th week they were 29.8 (95% CI, 15.54–41.73); 23.1 (95% CI, 11.51–25.05); and 19.1 (95% CI, 7.44–31.5). In predicting premature delivery, the sensitivity, specificity, positive predictive value, and negative predictive value of cervical length were 26%, 98%, 63.6%, and 93.57% for the 3rd percentile; 34%, 97%, 51%, and 94% for the 5th percentile; and 39%, 92%, 31%, and 94% for the 10th percentile.Transvaginal measurement of cervical length during routine fetal morphological examination between the 18th and 22nd week of pregnancy helps identify asymptomatic women at risk for preterm delivery.
Ultrasound in Obstetrics & Gynecology, 2002
AimThe aim of this study is to evaluate whether cervical length and morphology assessed by transvaginal ultrasound in women admitted in threatened labour, can predict preterm delivery prior to 34 weeks gestation.MethodOver a six‐month period, 25 women presenting with threatened preterm labour were prospectively recruited into the study. Women with ruptured membranes, chorioamnionitis or heavy vaginal bleeding requiring delivery were excluded. Transvaginal sonography for cervical length and morphology was performed shortly after admission. Demographic data, medical observations and interventions were recorded. Pregnancy outcomes were collected after delivery.ResultsThe mean gestation at recruitment was 27+4 weeks (range 21+°−32+6 weeks). 16% (4/25) of patients delivered before 34 weeks gestation. In the latter cases, the cervical lengths were all ≤ 25 mm and the interval between presentation and delivery was < 2 weeks. All pregnancies with a cervical length > 25 mm delivered af...
História, Ciências, Saúde-Manguinhos, 2016
Resumo A partir de etnografias realizadas em serviços públicos e privados do Rio de Janeiro, sustentamos que a difusão do fenômeno de (bio)medicalização varia de acordo com o estrato social das gestantes, produzindo corpos fetais e gestantes, assim como processos gestacionais, totalmente diversos, dependendo da camada social das mulheres atendidas. Tomando a premissa fundamental de que a biomedicalização consiste em uma transformação no processo de medicalização pela incorporação crescente da tecnociência à biomedicina, o universo observado evidencia diferentes estágios dessa transformação, acompanhando, de modo consistente, a estratificação social das grávidas submetidas ao exame de ultrassom.
Transvaginal Ultrasonographic Measurement of Cervical Length as a Predictor of Preterm Birth
Ultrasound Quarterly, 2010
The advent of effective interventions to prevent preterm delivery such as 17 hydroxyprogesterone and cerclage serve as an impetus to determine whether routine second trimester transvaginal cervical length screening can identify which women would benefit from these therapies. A systematic review was conducted, 957 abstracts were screened, 234 articles underwent full-text review, and 23 studies were included in the final analysis including 26,792 women. Data from relevant studies were pooled to produce summary estimates of sensitivity, specificity, and likelihood ratios using a random effects model. The ideal criteria of transvaginal cervical length measurements to predict preterm delivery are discussed.