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Transperineal versus transvaginal ultrasound cervical length measurement and preterm labor

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

The aim was to evaluate the agreement between and the reproducibility of transperineal and transvaginal ultrasound cervical length measurements performed by the duty obstetrical team in case of preterm labor. The acceptability of transperineal ultrasonography was also assessed.

Methods

Pregnant patients between 25 and 34 weeks of gestation with contractions and a clinically modified cervix were included. Order of ultrasonography examination (transperineal or transvaginal first) and rank of operator (resident or senior) were allocated randomly. Agreement was assessed using the intraclass correlation coefficient (ICC) and the Bland and Altman plot. The patient’s discomfort and preference for either method were assessed with a questionnaire.

Results

62 patients admitted for preterm labor between 25 and 34 weeks of gestation were included. Six seniors and nine residents took part in the study. Among the 51 patients with an interpretable transperineal ultrasound scan, median cervical length measurements with the transperineal and the transvaginal technique were, respectively, 25 mm (0–53) and 27 mm (4–51). Concordance was good with an ICC of 0.83 [IC 95 % = (0.73–0.90)]. Transperineal ultrasonography was preferred in 56.5 % of cases.

Conclusion

In case of preterm labor, cervical length measurement with transperineal ultrasonography seems reproducible and can be performed by the obstetric team on duty.

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References

  1. Iams JD, Goldenberg RL, Meis PJ, Mercer BM, Moawad A, Das A, Thom E, McNellis D, Copper RL, Johnson F, Roberts JM (1996) The length of the cervix and the risk of spontaneous premature delivery. National Institute of Child Health and Human Development Maternal Fetal Medicine Unit Network. N Engl J Med 334:567–572

    Article  CAS  PubMed  Google Scholar 

  2. Meijer-Hoogeveen M, Stoutenbeek P, Visser GH (2006) Methods of sonographic cervical length measurement in pregnancy: a review of the literature. J Matern Fetal Neonatal Med 19:755–762

    Article  PubMed  Google Scholar 

  3. Berghella V, Baxter JK, Hendrix NW (2013) Cervical assessment by ultrasound for preventing preterm delivery. Cochrane Database Syst Rev 1:CD007235

    PubMed  Google Scholar 

  4. Heath VC, Southall TR, Souka AP, Elisseou A, Nicolaides KH (1998) Cervical length at 23 weeks of gestation: prediction of spontaneous preterm delivery. Ultrasound Obstet Gynecol 12:312–317

    Article  CAS  PubMed  Google Scholar 

  5. Meijer-Hoogeveen M, Stoutenbeek P, Visser GH (2008) Transperineal versus transvaginal sonographic cervical length measurement in second- and third-trimester pregnancies. Ultrasound Obstet Gynecol 32:657–662

    Article  CAS  PubMed  Google Scholar 

  6. Cicero S, Skentou C, Souka A, To MS, Nicolaides KH (2001) Cervical length at 22–24 weeks of gestation: comparison of transvaginal and transperineal-translabial ultrasonography. Ultrasound Obstet Gynecol 17:335–340

    Article  CAS  PubMed  Google Scholar 

  7. Yazici G, Yildiz A, Tiras MB, Arslan M, Kanik A, Oz U (2004) Comparison of transperineal and transvaginal sonography in predicting preterm delivery. J Clin Ultrasound 32:225–230

    Article  PubMed  Google Scholar 

  8. Eggebo TM, Gjessing LK, Heien C, Smedvig E, Okland I, Romundstad P, Salvesen KA (2006) Prediction of labor and delivery by transperineal ultrasound in pregnancies with prelabor rupture of membranes at term. Ultrasound Obstet Gynecol 27:387–391

    Article  CAS  PubMed  Google Scholar 

  9. Carr DB, Smith K, Parsons L, Chansky K, Shields LE (2000) Ultrasonography for cervical length measurement: agreement between transvaginal and translabial techniques. Obstet Gynecol 96:554–558

    Article  CAS  PubMed  Google Scholar 

  10. Kurtzman JT, Goldsmith LJ, Gall SA, Spinnato JA (1998) Transvaginal versus transperineal ultrasonography: a blinded comparison in the assessment of cervical length at midgestation. Am J Obstet Gynecol 179:852–857

    Article  CAS  PubMed  Google Scholar 

  11. Owen J, Neely C, Northen A (1999) Transperineal versus endovaginal ultrasonographic examination of the cervix in the midtrimester: a blinded comparison. Am J Obstet Gynecol 181:780–783

    Article  CAS  PubMed  Google Scholar 

  12. Ozdemir I, Demirci F, Yucel O (2005) Transperineal versus transvaginal ultrasonographic evaluation of the cervix at each trimester in normal pregnant women. Aust N Z J Obstet Gynaecol 45:191–194

    Article  PubMed  Google Scholar 

  13. Bonett DG (2002) Sample size requirements for estimating intraclass correlations with desired precision. Stat Med 21:1331–1335

    Article  PubMed  Google Scholar 

  14. Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420–428

    Article  CAS  PubMed  Google Scholar 

  15. Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310

    Article  CAS  PubMed  Google Scholar 

  16. Hertzberg BS, Livingston E, DeLong DM, McNally PJ, Fazekas CK, Kliewer MA (2001) Ultrasonographic evaluation of the cervix: transperineal versus endovaginal imaging. J Ultrasound Med 20:1071–1078

    CAS  PubMed  Google Scholar 

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Conflict of interest

The authors report no conflict of interest.

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Authors and Affiliations

  1. Département de Gynécologie et Obstétrique, CHU Limoges, Hospital Mère Enfant, Avenue Larrey, 87042, Limoges, France

    T. Gauthier, A. Garuchet-Bigot, D. Kanoun, C. Catalan, H. Caly, J.-L. Eyraud & Y. Aubard

  2. Service de l’Information Médicale et de l’Evaluation, CHU Limoges, Unité Fonctionnelle de Recherche Clinique et de Biostatistique, 87042, Limoges, France

    B. Marin

Authors
  1. T. Gauthier
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  2. B. Marin
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  3. A. Garuchet-Bigot
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  4. D. Kanoun
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  5. C. Catalan
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  6. H. Caly
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  7. J.-L. Eyraud
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  8. Y. Aubard
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Correspondence to T. Gauthier.

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Gauthier, T., Marin, B., Garuchet-Bigot, A. et al. Transperineal versus transvaginal ultrasound cervical length measurement and preterm labor. Arch Gynecol Obstet 290, 465–469 (2014). https://doi.org/10.1007/s00404-014-3229-1

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  • DOI: https://doi.org/10.1007/s00404-014-3229-1

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