title: Transperineal versus transvaginal ultrasound cervical length measurement and preterm labor.
abstract: OBJECTIVE
  The aim was to evaluate the agreement between and the reproducibility of transperineal and transvaginal ultrasound cervical length measurements performed by the duty obstetrical team in case of preterm labor. The acceptability of transperineal ultrasonography was also assessed.
  
  
  METHODS
  Pregnant patients between 25 and 34 weeks of gestation with contractions and a clinically modified cervix were included. Order of ultrasonography examination (transperineal or transvaginal first) and rank of operator (resident or senior) were allocated randomly. Agreement was assessed using the intraclass correlation coefficient (ICC) and the Bland and Altman plot. The patient's discomfort and preference for either method were assessed with a questionnaire.
  
  
  RESULTS
  62 patients admitted for preterm labor between 25 and 34 weeks of gestation were included. Six seniors and nine residents took part in the study. Among the 51 patients with an interpretable transperineal ultrasound scan, median cervical length measurements with the transperineal and the transvaginal technique were, respectively, 25 mm (0-53) and 27 mm (4-51). Concordance was good with an ICC of 0.83 [IC 95 % = (0.73-0.90)]. Transperineal ultrasonography was preferred in 56.5 % of cases.
  
  
  CONCLUSIONS
  In case of preterm labor, cervical length measurement with transperineal ultrasonography seems reproducible and can be performed by the obstetric team on duty.
authors.affiliation: Département de Gynécologie et Obstétrique, CHU Limoges, Hospital Mère Enfant, Avenue Larrey, 87042, Limoges, France, tristan.gauthier@chu-limoges.fr.
authors.forename: T
authors.initials: T
authors.lastname: Gauthier
authors.forename: B
authors.initials: B
authors.lastname: Marin
authors.forename: A
authors.initials: A
authors.lastname: Garuchet-Bigot
authors.forename: D
authors.initials: D
authors.lastname: Kanoun
authors.forename: C
authors.initials: C
authors.lastname: Catalan
authors.forename: H
authors.initials: H
authors.lastname: Caly
authors.forename: J-L
authors.initials: JL
authors.lastname: Eyraud
authors.forename: Y
authors.initials: Y
authors.lastname: Aubard
mesh_terms: D000293:Adolescent; D000328:Adult; D054791:Cervical Length Measurement / Q000379:methods*; D002584:Cervix Uteri / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007752:Obstetric Labor, Premature; D057240:Patient Preference / Q000706:statistics & numerical data; D011247:Pregnancy; D011446:Prospective Studies; D015203:Reproducibility of Results; D055815:Young Adult