cervical length measurement

Endometriosis is a gynecologic disorder which causes dysmenorrhea and infertility. Early diagnosis of endometriosis can help prevent the necessity for invasive diagnostic procedures. Medical imaging has been widely utilized to diagnose various diseases without the need for invasive procedures. The purpose of this study was to investigate the cervical length in women with endometriosis.

In this case-control study, the case group consisted of nulliparous women with endometriosis, while the control group comprised nulliparous women without endometriosis. A total of 42 individuals were included in each group. Cervical length was measured using transvaginal ultrasound from the external os to the internal os. The patients in the case group underwent laparoscopy to confirm the diagnosis. Pearson chi-square test and Fisher’s exact test were employed to compare categorical variables with a p<0.05 considered statistically significant.

In both groups, there were no notable variations in any of the demographic characteristics. However, the severity of dysmenorrhea was significantly different between the two groups (p=0.01). The average diameter of the mediolateral cervix (29.48±6.2 and 27.14±3.8) was statistically significant between the patient group and control group, respectively (p=0.04). The mediolateral width may have a positive predictive effect on the presence of endometriosis, while cervical length appears to have a protective effect against endometriosis.

Demographic data do not predict endometriosis. This study suggests that mediolateral width in transvaginal sonography can serve as a minimally invasive diagnostic tool for endometriosis, showing correlation with endometriosis symptoms like dysmenorrhea and dyspareunia.

Preterm birth (PB) is associated with significant morbidities in surviving infants. Accurate prediction of PB is essential for effective prevention and management. Continuous monitoring of cervical parameters has shown utility in several studies.

This study aimed to investigate the role of the anterior uterocervical angle (UCA) in predicting the incidence of PB.

A prospective, descriptive-analytic study was conducted with 165 pregnant women referred to the prenatal care clinic at Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran, in 2021 - 2022. Participants were selected through convenience sampling. Cervical parameters, including UCA, length, and width, were measured via vaginal ultrasound during each trimester. All women were followed until delivery to determine PB incidence. Data were analyzed using descriptive and analytical statistical tests, including the chi-square or Fisher’s exact test and the independent samples t -test or Mann-Whitney U test.

Among the participants, 12 (7.3%) experienced preterm delivery. Cervical length was significantly shorter in women with PB during the second trimester (32.58 ± 4.77 mm vs. 34.68 ± 3.80 mm, P = 0.042) and third trimester (30.00 ± 4.74 mm vs. 32.77 ± 3.88 mm, P = 0.022). The mean UCA in women with preterm delivery was higher than in those with term delivery during both the second (90.58 ± 17.21° vs. 88.66 ± 16.76°) and third (100.25 ± 14.56° vs. 98.89 ± 17.78°) trimesters (P > 0.05). A UCA greater than 105° in the second trimester had a sensitivity of 16.7% and specificity of 81.5% for predicting PB. In the third trimester, a UCA greater than 105° showed a sensitivity of 58.3% and specificity of 60.7% for predicting PB.

This study emphasizes the importance of regular cervical parameter measurements throughout pregnancy. A UCA greater than 105° in the third trimester appears to be a potential predictor of PB.

This study aimed to assess the diagnostic value of novel ultrasonographic markers, Anterior Uterocervical Angle (AUA), Cervical Consistency Index (CCI) and Cervical Glandular Area (CGA) in the Prediction of Preterm Birth (PTB), in a general population.
We conducted a prospective cohort study on singleton gestations between 16 -24 weeks undergoing transvaginal sonography for Cervical Length (CL) screening. AUA, CCI and CGA were evaluated. The primary outcome was prediction of spontaneous PTB before 37 weeks’ gestation by UCA, CCI and CGA. The secondary outcome was evaluating performance of these markers alone and in combination with CL to predict PTB.
A total of 310 women were studied. The rate of PTB in this population was 10.6 % for delivery before 37 weeks. In the PTB group, the shorter CL, the wider AUA and the lower CCI were significant, but the CGA width and area were not significantly different in term and PTB groups. The optimal cut-off based on the ROC curve was 33.15 mm for CL (sensitivity: 57%; specificity: 68%), 102.5 degrees for AUA (sensitivity: 50%; specificity: 80%), and 60.3% for CCI (sensitivity: 43%; specificity: 68%).
Our data indicate that the combination of CL and CCI (positive likelihood ratio:3; negative likelihood ratio:0.7) and the combination of CL and AUA (positive likelihood ratio:4.8; negative likelihood ratio:0.76) are better methods for the prediction of spontaneous PTB before 37 weeks; and can be used as a screening tool in the second trimester.

Preterm labor is a major cause of perinatal morbidity and mortality and it might be predicted by assessing the cervical change.

To assess the association between absence of cervical gland area (CGA) and spontaneous preterm labor (SPTL).

This prospective cohort study was performed on 200 singleton pregnant women with a history of SPTL, second-trimester abortion in the previous pregnancy or lower abdominal pain in current pregnancy. Each patient underwent one transvaginal ultrasound examination between 14-28 wk of gestation. Cervical length was measured and CGA was identified and their relationship with SPTL before 35 and 37 wk gestation was evaluated using STATA software version 10.

The mean of cervical length was 36.5 mm (SD=8.4), the shortest measurement was 9 mm, and the longest one was 61 mm. Short cervical length (≤18mm) was significantly associated with SPTL before 35 and 37 wk gestation.
Cervical gland area (the hypoechogenic or echogenic area around the cervical canal) was present in 189 (94.5%) patients. Absent of CGA had a significant relationship with SPTL before 35 and 37 wk gestation (p=0.01 and p

Our study showed that cervical gland area might be an important predictor of SPTL which should be confirmed with further researches.

Preterm delivery is defined as delivery between the 20th and 37th week of pregnancy that affects 7% to 11% of all pregnancies and continues to be the primary cause of perinatal mortality and morbidity worldwide.. The aim of this study was to investigate the feasibility and reliability of cervical length (CL) measurement by transperineal and transvaginal ultrasonography (TPUS and TVUS, respectively) in the second trimester..Patients and This cross-sectional study included 196 pregnant women at 18th to 24th weeks of gestation who were referred to Zeinabieh and Hafez hospitals, affiliated with Shiraz University of Medical Sciences. CL was measured by TVUS and TPUS and the measurements between 18 and 24 weeks of gestation were used to predict preterm delivery.. Preterm delivery was recorded in 16 pregnant women (8.2%). A statistically significant difference in mean of measured CL by TVUS and TPUS was found between preterm and term delivery groups (TVUS, 33.5 ± 4.1 mm in term and 21.8 ± 6.0 mm in preterm delivery, P < 0.001; and TPUS, 34.2 ± 4.6 mm in term and 22.6 ± 5.0 mm in preterm delivery). Areas under the receptor operative characteristic curves were 0.973 and 0.978 for the TVUS and TPUS, respectively. There was a strong correlation between the TVUS and TPUS at a cutoff point of ≤ 28 mm with sensitivity of 93.75% and specificity of 92.74%.. TPUS can be an appropriate alternative for predicting preterm delivery with a comparable accuracy to TVUS..