[Value of cervical echography in the prediction of premature delivery: literature review].
Preterm delivery is the leading cause of neonatal mortality. Thus predicting a preterm delivery is a major obstetrical problem. Endovaginal ultrasonography is a highly reliable and reproducible method of cervical examination. Unlike with a digital cervical examination the entire length of the endocervical canal can be measured. Using this tool, measuring the dilatation of the internal os does not require the examining finger to be placed inside the endocervical canal. Therefore, the internal os can be measured even if the external os is closed. While a digital examination assesses the "dilatability" of the internal os, an ultrasonography assesses the "true degree of dilatation". In a low-risk population endovaginal cervical ultrasonography helps rule out a preterm delivery if cervical length is long enough. It can also detect cervical incompetence. In a high-risk population, women whose cervix is longer than 30 millimeters can be identified. These women have over 80% chance to deliver on or after 36 weeks of pregnancy. Preliminary studies suggest that performing an endovaginal ultrasonography could decrease the number of false positive clinical diagnosis of modified cervix and thus, save long, expensive and inefficient hospital stays. Prospective randomized, controlled studies are needed to confirm these results.
Dupuis
O
O
Fédération Femme Mère Nouveau-né, Hôpital Edouard-Herriot, Lyon.
Thoulon
J M
JM
Mellier
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G
D020070:Cervical Ripening; D002584:Cervix Uteri / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D007752:Obstetric Labor, Premature / Q000000981:diagnostic imaging* / Q000473:pathology; D010808:Physical Examination; D011237:Predictive Value of Tests; D011247:Pregnancy; D015203:Reproducibility of Results; D014463:Ultrasonography