[Intravaginal ultrasonography of the uterine cervix: hope in the campaign against premature births].
Transvaginal ultrasound of the cervix provides an objective and non-invasive method for assessing cervical status: cervical measurements, anatomy (wedge, "funneling" of the amniotic sac protruding into the internal os), functional examination (dynamic modifications of the internal orifice in response to uterine contractions or pressure on the fundus). In patients with symptoms (that is, presenting preterm labor), the positive predictive value of cervical ultrasound is far better than that of digital examination and allows better screening of high-risk patients; in addition, its negative predictive value is excellent, which should reduce unnecessary treatments related to prevention of preterm births (excessive tocolysis and unnecessary or prolonged hospitalization) without increasing the incidence of such births. In high-risk asymptomatic patients, ultrasound of the cervix has been proposed to reduce the number of cerclage in cases where the situation is unclear. Finally, in the general population, it could be added to the second trimester ultrasound, to improve screening of patients at risk of preterm delivery.
Rozenberg
P
P
Service de Gynécologie et Obstétrique, Centre Hospitalier Intercommunal Léon Touhladjian, Faculté de Médecine Paris Ouest (université Paris V), Poissy.
D000650:Amnion / Q000000981:diagnostic imaging; D002584:Cervix Uteri / Q000000981:diagnostic imaging*; D019160:Endosonography; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008403:Mass Screening; D007752:Obstetric Labor, Premature / Q000000981:diagnostic imaging / Q000517:prevention & control*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D018566:Pregnancy, High-Risk; D015145:Tocolysis; D016216:Ultrasonography, Prenatal; D014590:Uterine Contraction
L'échographie endovaginale du col utérin: un espoir dans la lutte contre la prématurité.