Transvaginal ultrasound cervical length for prediction of spontaneous labour at term: a systematic review and meta-analysis.
BACKGROUND
The possibility to predict the delivery date is a question frequently raised by pregnant women. However, a clinician has currently little to predict when a woman at term will deliver.


OBJECTIVE
To evaluate the predictive accuracy of transvaginal ultrasound (TVU) cervical length (CL) for spontaneous onset of labour in singleton gestation enrolled at term by a meta-analysis.


METHODS
We performed a literature search in electronic databases.


METHODS
We included only studies assessing the accuracy of TVU CL in prediction of spontaneous onset of labour in singleton gestations with vertex presentation who were enrolled at term.


METHODS
The primary outcome was the accuracy of CL for prediction of spontaneous labour within 7 days. Pooled sensitivities and specificities were calculated.


RESULTS
Five studies including 735 singleton gestations were included. For the prediction of spontaneous labour within 7 days for CL <30 mm the pooled sensitivity was 64% and pooled specificity was 60%. The higher the CL, the better the sensitivity; the lower the CL, the better the specificity. A woman with a singleton gestation at term and a TVU CL of 30 mm has a <50% chance of delivering within 7 days, while one with a TVU CL of 10 mm has an over 85% chance of delivery within 7 days.


CONCLUSIONS
TVU CL at term has moderate value in predicting the onset of spontaneous labour. A woman with a TVU CL of 10 mm or less has a high chance of delivering within a week.


CONCLUSIONS
Cervical length at term has moderate value in predicting the onset of spontaneous labour.
Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
G
G
Saccone
Department of Law, Economics, Management and Quantitative Methods, University of Sannio, Benevento, Italy.
B
B
Simonetti
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
V
V
Berghella
D000328:Adult; D054791:Cervical Length Measurement / Q000295:instrumentation*; D020070:Cervical Ripening / Q000502:physiology*; D002584:Cervix Uteri / Q000000981:diagnostic imaging*; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D012680:Sensitivity and Specificity; D047929:Term Birth; D014621:Vagina / Q000000981:diagnostic imaging*
Cervical length; labour; ultrasound