Sonographic evaluation of cervical length changes during normal pregnancy
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Sonographic evaluation of the gravid cervix is important for the assessment of cervical incompetence, preterm labor and placenta
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Internet Journal of Medical Update, Vol. 4, No. 1, January 2009 Original Work Sonographic evaluation of cervical length changes during normal pregnancy Dr. A O Imo* MBBS FWACS FICS, Mr. A C Ugwu** B Sc M Sc PGC-CT and Professor I J Okoye*** MBBS FMCR FICS *Department of Radiology, Ebonyi State, University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria **Department of Medical Radiography, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria ***Department of Radiology, University of Nigeria Teaching Hospital, Enugu, Enugu State, Nigeria (Received 25 March 2008 and accepted 24 July 2008) ABSTRACT: This study was aimed to establish reference values of cervical length in normal pregnancy. We studied a cross-sectional sample of 144 pregnant women by transabdominal sonography. The inclusion criteria were sonographic confirmation of gestational age, the absence of any risk factors for preterm birth, and uncomplicated pregnancy. Cervical length was measured in a straight line. Height, age and weight of patients were also obtained. There was a relationship between gestational age and cervical length, which could be described with a linear regression (R = 0.44; P<0.05). Our study shows an increase in cervical length with gestational age. Reference ranges constructed for the whole gestational period could be more clinically applicable and useful than a single cut off value for more efficient prevention and management of preterm birth. KEYWORDS: Transabdominal sonography; cervical length; normal pregnancy; gestational age INTRODUCTION Sonographic evaluation of the gravid cervix is Detection of incompetence of the cervix is based important for the assessment of cervical on demonstration of a shortened and dilated incompetence, preterm labor and placenta Cervix less than 3.0cm15. Establishment of this previa1-12. Premature delivery affects 7% to 11% diagnosis early enough may lead to saving the of all newborn infants and remains a major cause pregnancy by circlage16. Over the last few years, of perinatal morbidity and mortality. Despite the investigators have begun to study changes in increasingly varied choice of therapies and cervical length by sonographic scanning, perhaps treatments available to present day obstetricians in an attempt to overcome the limitations for the management of pregnancy, no significant inherent in the subjectivity of clinical changes have been reported so far in preterm examination of the cervix. The manual birth (PTB) rates, which of course, vary widely assessment of the cervical length is subjective among different populations studied because of and has a poor intra observer variability17. The racial, social, economic, and environmental literature actually reports different cutoff values factors. The proportion of women at risk of PTB for cervical length measurements, which might is about 7% in France and 8% to 9% in Italy13. In theoretically enable identification of up to 100% the United States, where the rate has been of PTBs18. Literature search did not reveal any unchanged for the last 3 decades, the PTB rate is previous study in this locality. 10% to 11%14. (Corresponding Author: Mr. A. C. Ugwu, Department of Medical Radiography, Faculty of Health Sciences & Technology, Nnamdi Azikiwe University, Nigeria, Email: tonybullng@yahoo.ca ) 19 Copyrighted © by Dr. Arun Kumar Agnihotri. All right reserved Downloaded from http://www.geocities.com/agnihotrimed
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