title: Comparison of two-dimensional and three-dimensional ultrasound in the assessment of the cervix to predict preterm delivery.
abstract: This study sought to determine whether 3-D transvaginal ultrasound (3D-TVS), compared with the 2-D transvaginal approach (2D-TVS), offers a better identification of some specific features of the uterine cervix that could be useful in the prediction of spontaneous preterm delivery (PTD). A total of 103 women with singleton pregnancies were prospectively evaluated with 2D-TVS and 3D-TVS in the second or third trimester of pregnancy. Statistical analysis was performed with Wilcoxon matched-pairs test, chi2 and Pearson test (p<0.05 was considered significant) and receiver operating characteristic (ROC) curve analysis. Significant differences between these approaches were found for cervical length (p<0.001). A significant correlation was identified between 3D-TVS cervical length and the interval between ultrasound examination and delivery as well as the gestational age at delivery (both p<0.001). ROC curve identified a threshold for 3D-TVS cervical length of 35 mm as an optimal predictor of PTD in the second trimester (sensitivity 100%, specificity 88%). 3D-TVS evaluation of the cervix in pregnancy seems to be an effective, noninvasive method for predicting PTD risk.
authors.affiliation: Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy. severi@unisi.it
authors.forename: Filiberto Maria
authors.initials: FM
authors.lastname: Severi
authors.forename: Caterina
authors.initials: C
authors.lastname: Bocchi
authors.forename: Pasquale
authors.initials: P
authors.lastname: Florio
authors.forename: Enrico
authors.initials: E
authors.lastname: Picciolini
authors.forename: Gemma
authors.initials: G
authors.lastname: D'Aniello
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
mesh_terms: D000328:Adult; D000886:Anthropometry / Q000379:methods; D002584:Cervix Uteri / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007752:Obstetric Labor, Premature / Q000000981:diagnostic imaging* / Q000473:pathology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000379:methods*