Comparison of two-dimensional and three-dimensional ultrasound in the assessment of the cervix to predict preterm delivery.
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.
Severi
Filiberto Maria
FM
Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy. severi@unisi.it
Bocchi
Caterina
C
Florio
Pasquale
P
Picciolini
Enrico
E
D'Aniello
Gemma
G
Petraglia
Felice
F
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*