| 1. Blencowe H, Cousens S, Oestergaard MZ, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet 2012;379:2162-72. |
Review/Other-Dx |
738 datapoints |
To report worldwide, regional, and national estimates of preterm birth rates for 184 countries in 2010 with time trends for selected countries, and provide aquantitative assessment of the uncertainty surrounding these estimates. |
In 2010, an estimated 14·9 million babies (uncertainty range 12·3–18·1 million) were born preterm, 11·1% of all livebirths worldwide, ranging from about 5% in several European countries to 18% in some African countries. More than 60% of preterm babies were born in south Asia and sub-Saharan Africa, where 52% of the global livebirths occur. Preterm birth also aff ects rich countries, for example, USA has high rates and is one of the ten countries with the highest numbers of preterm births. Of the 65 countries with estimated time trends, only three (Croatia, Ecuador, and Estonia), had reduced preterm birth rates 1990–2010. |
4 |
| 2. Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Drake P. Births: Final Data for 2016. Natl Vital Stat Rep 2018;67:1-55. |
Review/Other-Dx |
7 year data |
To present 2016 data on U.S. births according to a wide variety of characteristics. |
A total of 3,945,875 births were registered in the United States in 2016, down 1% from 2015. Compared with rates in 2015, the general fertility rate declined to 62.0 per 1,000 women aged 15–44. The birth rate for females aged 15–19 fell 9% in 2016. Birth rates declined for women in their 20s but increased for women in their 30s and early 40s. The total fertility rate declined to 1,820.5 births per 1,000 women in 2016. The birth rate for unmarried women declined, while the rate for married women increased. More than three-quarters of women began prenatal care in the first trimester of pregnancy (77.1%) in 2016, while 7.2% of all women smoked during pregnancy. The cesarean delivery rate declined for the fourth year in a row. Medicaid was the source of payment for 42.6% of all 2016 births. The preterm birth rate rose for the second straight year, and the rate of low birthweight increased 1%. Twin and triplet and higher-order multiple birth rates declined, although the changes were not statistically significant. |
4 |
| 3. Institute of Medicine (US) Committee on Understanding Premature Birth and Assuring Healthy Outcomes. Preterm Birth: Causes, Consequences, and Prevention. In: Behrman RE, Butler AS, eds. Washington (DC): National Academies Press (US); 2007. |
Review/Other-Dx |
N/A |
To propose a research agenda for investigating the problem of preterm birth that is intended to help focus and direct research efforts. |
No results stated in abstract. |
4 |
| 4. Iams JD, Goldenberg RL, Meis PJ, et al. The length of the cervix and the risk of spontaneous premature delivery. National Institute of Child Health and Human Development Maternal Fetal Medicine Unit Network. N Engl J Med. 1996;334(9):567-572. |
Observational-Dx |
2,915 women |
Prospective, multicenter study to measure cervical length (using TVUS), and to document incidence of spontaneous delivery before 35 weeks. To calculate RR for preterm delivery based on cervical length. |
RR of preterm delivery increases as cervical length decreases. At 24 weeks gestation age (RR was: (also done at 28 weeks): Cervix length at or below 40 mm (75th percentile); RR=1.98. Cervix length at or below 35 mm (50th percentile); RR=2.35. Cervical length at or below 30 mm (25th percentile); RR=3.79. Cervical length at or below 26 mm (10th percentile); RR=6.19. Cervical length at or below 22 mm (5th percentile); RR=9.49. Cervical length at or below 13mm (1st percentile) RR=13.99. |
3 |
| 5. Berghella V, Rafael TJ, Szychowski JM, Rust OA, Owen J. Cerclage for short cervix on ultrasonography in women with singleton gestations and previous preterm birth: a meta-analysis. Obstet Gynecol 2011;117:663-71. |
Meta-analysis |
5 randomised controlled trials |
To estimate if cerclage prevents preterm birth and perinatal mortality and morbidity in women with previous preterm birth, singleton gestation, and short cervical length in a meta-analysis of randomized trials. |
Patient level data abstraction and analysis were accomplished by two independent investigators. Five trials met inclusion criteria. In women with a singleton gestation, previous spontaneous preterm birth, and cervical length less than 25 mm before 24 weeks of gestation, preterm birth before 35 weeks of gestation was 28.4% (71/250) in the cerclage compared with 41.3% (105/254) in the no cerclage groups (relative risk 0.70, 95% confidence interval 0.55– 0.89). Cerclage also significantly reduced preterm birth before 37, 32, 28, and 24 weeks of gestation. Composite perinatal mortality and morbidity were significantly reduced (15.6% in cerclage compared with 24.8% in no cerclage groups; relative risk 0.64, 95% confidence interval 0.45– 0.91). |
Good |
| 6. Fonseca EB, Celik E, Parra M, Singh M, Nicolaides KH. Progesterone and the risk of preterm birth among women with a short cervix. N Engl J Med. 2007;357(5):462-469. |
Experimental-Dx |
250 women |
Multicenter, randomized trial was designed to evaluate the effect of vaginal progesterone on the incidence of spontaneous early preterm delivery in asymptomatic women found at routine mid-trimester screening to have a short cervix. |
Spontaneous delivery before 34 weeks of gestation was less frequent in the progesterone group than in the placebo group (19.2% vs. 34.4%; relative risk, 0.56; 95% confidence interval [CI], 0.36 to 0.86). Progesterone was associated with a nonsignificant reduction in neonatal morbidity (8.1% vs. 13.8%; relative risk, 0.59; 95% CI, 0.26 to 1.25; P=0.17). There were no serious adverse events associated with the use of progesterone. |
1 |
| 7. Goya M, Pratcorona L, Merced C, et al. Cervical pessary in pregnant women with a short cervix (PECEP): an open-label randomised controlled trial. Lancet. 2012;379(9828):1800-1806. |
Experimental-Tx |
385 pregnant women |
Randomised, controlled trial to investigate whether the insertion of a cervical pessary in women with a short cervix identified by use of routine transvaginal scanning at 20-23 weeks of gestation reduces the rate of early preterm delivery. |
385 pregnant women with a short cervix were assigned to the pessary (n=192) and expectant management groups (n=193), and 190 were analysed in each group. Spontaneous delivery before 34 weeks of gestation was significantly less frequent in the pessary group than in the expectant management group (12 [6%] vs 51 [27%], odds ratio 0.18, 95% CI 0.08-0.37; p<0.0001). No serious adverse effects associated with the use of a cervical pessary were reported. |
1 |
| 8. Hassan SS, Romero R, Vidyadhari D, et al. Vaginal progesterone reduces the rate of preterm birth in women with a sonographic short cervix: a multicenter, randomized, double-blind, placebo-controlled trial. Ultrasound Obstet Gynecol. 2011;38(1):18-31. |
Experimental-Dx |
458 women |
Multicenter, randomized, double-blind, placebo-controlled trial to determine the efficacy and safety of using micronized vaginal progesterone gel to reduce the risk of preterm birth and associated neonatal complications in women with a sonographic short cervix. |
Women allocated to receive vaginal progesterone had a lower rate of preterm birth before 33 weeks than did those allocated to placebo (8.9% (n=21) vs 16.1% (n=36); relative risk (RR), 0.55; 95% CI, 0.33-0.92; P=0.02). The effect remained significant after adjustment for covariables (adjusted RR, 0.52; 95% CI, 0.31-0.91; P=0.02). Vaginal progesterone was also associated with a significant reduction in the rate of preterm birth before 28 weeks (5.1% vs 10.3%; RR, 0.50; 95% CI, 0.25-0.97; P=0.04) and 35 weeks (14.5% vs 23.3%; RR, 0.62; 95% CI, 0.42-0.92; P=0.02), respiratory distress syndrome (3.0% vs 7.6%; RR, 0.39; 95% CI, 0.17-0.92; P=0.03), any neonatal morbidity or mortality event (7.7% vs 13.5%; RR, 0.57; 95% CI, 0.33-0.99; P=0.04) and birth weight < 1500 g (6.4% (15/234) vs 13.6% (30/220); RR, 0.47; 95% CI, 0.26-0.85; P=0.01). There were no differences in the incidence of treatment-related adverse events between the groups. |
1 |
| 9. Society for Maternal-Fetal Medicine (SMFM) Publications Committee.. The choice of progestogen for the prevention of preterm birth in women with singleton pregnancy and prior preterm birth. Am J Obstet Gynecol. 216(3):B11-B13, 2017 Mar. |
Review/Other-Tx |
N/A |
To reaffirm the choice of progestogen for women with a singleton gestation and a prior spontaneous spontaneous preterm birth (PTB). |
No results stated. |
4 |
| 10. Glanc P, Nyberg DA, Khati NJ, et al. ACR Appropriateness Criteria® Multiple Gestations. J Am Coll Radiol 2017;14:S476-S89. |
Review/Other-Dx |
N/A |
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for ACR Appropriateness Criteria Multiple Gestations. |
No results stated in abstract. |
4 |
| 11. American College of Radiology. ACR Appropriateness Criteria®: Suspected Placenta Accreta Spectrum Disorder. Available at: https://acsearch.acr.org/docs/3102403/Narrative/. |
Review/Other-Dx |
N/A |
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for a specific clinical condition. |
No abstract available. |
4 |
| 12. Boelig RC, Feltovich H, Spitz JL, Toland G, Berghella V, Iams JD. Assessment of Transvaginal Ultrasound Cervical Length Image Quality. Obstet Gynecol. 129(3):536-541, 2017 Mar. |
Review/Other-Dx |
788 images |
To use data from the Cervical Length Education and Review program to evaluate the quality of transvaginal cervical length ultrasonography by trainedimagers (ie, ultrasonographers, radiologists, perinatologists). |
Six hundred eighty-seven candidates submitted 3,748 images between June 10, 2012, and August 18, 2016. Eighty-five percent of candidates were ultrasonographers. Of the 687 initial batches submitted, 105 (15%) did not pass. Eight hundred thirty-seven images (22%) of all images failed at least one criterion; the most common image deficiencies were in “anterior width of cervix equals the posterior width” (33%), “failure to visualize” the internal or external os (29%), “cervix occupies 75% of image and bladder area visible” (33%), and incorrect caliper placement (24%). Two hundred fifty-six (7%) of all images failed to meet our criteria for adequate image acquisition. |
4 |
| 13. Iams JD, Grobman WA, Lozitska A, et al. Adherence to criteria for transvaginal ultrasound imaging and measurement of cervical length. Am J Obstet Gynecol. 209(4):365.e1-5, 2013 Oct. |
Review/Other-Dx |
327 sonographers |
To assess adherence by evaluating images submitted to certify research sonographers for participation in a clinical trial. |
327 sonographers submitted 4905 images. 271 sonographers (83%) were certified on the first, 41 (13%) on the second, and 2 (0.6%) on the third submission. 13 never achieved certification. Of 314 who passed, 196 submitted 15 acceptable images that were appropriately measured for all five women. There were 1277 deficient images: 493 were acceptable but incorrectly measured images from sonographers who passed certification because mismeasurement occurred no more than twice. Of 784 deficient images submitted by sonographers who failed the certification, 471 were rejected because of improper measurement (caliper placement and/or failure to identify the shortest best image), and 313 because of failure to obtain a satisfactory image (excessive compression, required landmarks not visible, incorrect image size, brief examination, and/or full maternal bladder) |
4 |
| 14. Hernandez-Andrade E, Garcia M, Ahn H, et al. Strain at the internal cervical os assessed with quasi-static elastography is associated with the risk of spontaneous preterm delivery at <=34 weeks of gestation. J Perinat Med. 43(6):657-66, 2015 Nov. |
Observational-Dx |
45 women |
To evaluate the association between cervical strain assessed with quasi-static elastography and spontaneous preterm delivery. |
The prevalence of spontaneous preterm delivery at < 37 weeks of gestation was 8.2% (n = 45), and that at = 34 weeks of gestation was 3.8% (n = 21). Strain in the internal cervical os was the only elastography value associated with spontaneous preterm delivery. Women with strain values in the 3rd and 4th quartiles had a significantly higher risk of spontaneous preterm delivery at = 34 weeks and at < 37 weeks of gestation when compared to women with strain values in the lowest quartile. When adjusting for a short cervix ( < 25 mm) and gestational age at examination, women with strain values in the 3rd quartile maintained a significant association with spontaneous preterm delivery at = 34 weeks (OR 9.0; 95% CI, 1.1–74.0; P = 0.02), whereas women with strain values in the highest quartile were marginally more likely than women with lowest quartile strain values to deliver spontaneously at < 37 weeks of gestation (OR 95% CI: 2.8; [0.9–9.0]; P = 0.08). |
3 |
| 15. Hernandez-Andrade E, Hassan SS, Ahn H, et al. Evaluation of cervical stiffness during pregnancy using semiquantitative ultrasound elastography. Ultrasound Obstet Gynecol. 41(2):152-61, 2013 Feb. |
Observational-Dx |
262 patients |
To evaluate cervical stiffness during pregnancy using ultrasound-derived elastography, a method used to estimate the average tissue displacement (strain) within a defined region of interest when oscillatory compression is applied. |
A total of 1557 strain estimations were performed in 262 patients at 8–40 weeks of gestation. Adjusting for other sources of variation, (1) cervical tissue strain estimates obtained in the endocervical canal were on average 33% greater than those obtained in the entire cervix; (2) measurements obtained in the cross-sectional plane of the external cervical os and sagittal plane were 45% and 13% greater than those measured in the crosssectional plane of the internal cervical os, respectively; (3) mean strain rates were 14% and 5% greater among parous women with and without a history of preterm delivery compared with those of nulliparous women, respectively, and were on average 13% greater among women with a cervical length of between 25 and 30mm compared to those with a cervical length of>30 mm; and (4) cervical tissue strain was more strongly associated with cervical length than with gestational age. |
3 |
| 16. Hernandez-Andrade E, Romero R, Korzeniewski SJ, et al. Cervical strain determined by ultrasound elastography and its association with spontaneous preterm delivery. J Perinat Med. 42(2):159-69, 2014 Mar. |
Observational-Dx |
189 women |
To determine if there is an association between cervical strain, evaluated using ultrasound elastography, and spontaneous preterm delivery (sPTD) < 37 weeks of gestation. |
The prevalence of sPTD was 11% (21/189). Strain values from each of the six cervical regions correlated weakly with cervical length (from r = –0.24, P < 0.001 to r = –0.03, P = 0.69). Strain measurements obtained in a cross sectional view of the internal cervical os were significantly associated with sPTD. Women with strain values = 25th centile in the endocervical canal (0.19) and in the entire cervix (0.14) were 80% less likely to have a sPTD than women with strain values > 25th centile [endocervical: odds ratio (OR) 0.2; 95% confidence interval (CI), 0.03–0.96; entire cervix: OR 0.17; 95% CI, 0.03– 0.9]. Additional adjustment for gestational age, race, smoking status, parity, maternal age, pre-pregnancy body mass index, and previous preterm delivery did not appreciably alter the magnitude or statistical significance of these associations. Strain values obtained from the external cervical os and from the sagittal view were not associated with sPTD. |
3 |
| 17. Wozniak S, Czuczwar P, Szkodziak P, Milart P, Wozniakowska E, Paszkowski T. Elastography in predicting preterm delivery in asymptomatic, low-risk women: a prospective observational study. BMC Pregnancy Childbirth. 14:238, 2014 Jul 21. |
Observational-Dx |
333 women |
To estimate the potential value of elastographic evaluation of internal cervical os stiffness at 18-22 weeks of pregnancy in low risk, asymptomatic women in the prediction of spontaneous preterm delivery. |
The number of preterm deliveries (<37 weeks of pregnancy) was significantly higher in the red and yellow groups, than in the blue and purple groups. The sensivity, specifity, NPV and PPV for both red and yellow internal os assessment in predicting preterm delivery were 85.7%, 97.6%, 98.3% and 81.1% respectively. |
3 |
| 18. Fruscalzo A, Londero AP, Frohlich C, Meyer-Wittkopf M, Schmitz R. Quantitative elastography of the cervix for predicting labor induction success. Ultraschall Med. 36(1):65-73, 2015 Feb. |
Observational-Dx |
77 patients |
To evaluate the role of quantitative elastography of the cervix in the prediction of successful labor induction compared to the Bishop score (BS) and ultrasound cervical length (CL). |
We analyzed 77 patients with a mean gestational age of 39.7 ± 1.5 weeks of gestation and a mean strain of 0.75 ± 0.17. The TS significantly predicted a failure of labor induction, which occurred in 4 cases, both in mono- and multivariate analysis, independently of the functional cervical length (TS 0.6 ± 0.1). No correlation was found between the TS and other outcomes. The Bishop score and functional cervical length were found to predict only an early response to labor induction (time to active labor < 24 h, time to vaginal delivery < 36 h and PG usage < 6mg). The diagnostic accuracy was slightly but not significantly improved if both TS and CL were considered. |
2 |
| 19. Hee L, Rasmussen CK, Schlutter JM, Sandager P, Uldbjerg N. Quantitative sonoelastography of the uterine cervix prior to induction of labor as a predictor of cervical dilation time. Acta Obstet Gynecol Scand. 93(7):684-90, 2014 Jul. |
Observational-Dx |
69 women |
To evaluate how the approximate Young’s modulus of the uterine cervix assessed by quantitative sonoelastography in patients undergoing induction of labor is associated with the cervical dilation time and to evaluate the approximate Young’s modulus as a predictor of prolonged cervical dilation time. |
The approximate Young’s modulus was associated with the cervical dilation time during active labor (R2 log = 0.24, p < 0.01) and predicted prolonged duration of cervical dilation time (>330 min) with the area under the receiver operating characteristic (ROC) curve of 0.71, sensitivity 74%, and specificity 69%. Equivalent figures for the Bishop’s score were R2 log = 0.02 (p = 0.37), the area under the ROC curve 0.53, sensitivity 53%, and specificity 46%. For the cervical length measurements the corresponding results were: R2 log = 0.02, p = 0.35, area under the ROC curve 0.57, sensitivity 66% and specificity 54%. The intra-observer and inter-observer intraclass correlations were 88% and 58%, respectively, with quantitative elastography. |
2 |
| 20. Hwang HS, Sohn IS, Kwon HS. Imaging analysis of cervical elastography for prediction of successful induction of labor at term. J Ultrasound Med. 32(6):937-46, 2013 Jun. |
Observational-Dx |
145 women |
To evaluate the value of imaging analysis of cervical elastography to predict successful induction of labor in nulliparous women at term. |
The areas under the curves for the cervical length, cervical area, Bishop score, mean elastographic index, and cervical hard area were 0.63, 0.64, 0.47, 0.68, and 0.70, respectively, for onset of active labor within 9 hours and 0.70, 0.68, 0.63, 0.71, and 0.76 for delivery within 24 hours. The combination of cervical length and elastographic data was more predictable for successful labor induction (P < .05). |
1 |
| 21. Muscatello A, Di Nicola M, Accurti V, et al. Sonoelastography as method for preliminary evaluation of uterine cervix to predict success of induction of labor. Fetal Diagn Ther. 35(1):57-61, 2014. |
Observational-Dx |
53 subjects |
To determine the sensitivity of sonoelastography in the evaluation of the cervix to predict the success of induction. |
Statistical analysis revealed a significant difference of prevalence of spontaneous delivery (EI1–3 82.75%, EI4–5 45.8%) versus cesarean section (EI1–3 17.25%, EI4–5 54.16%) (p = 0.0072). The diagnostic validity of EI was evaluated using the receiver operating characteristic curve and cut-off of the predictive value was EI3. |
3 |
| 22. von Schoning D, Fischer T, von Tucher E, et al. Cervical sonoelastography for improving prediction of preterm birth compared with cervical length measurement and fetal fibronectin test. J Perinat Med. 43(5):531-6, 2015 Sep. |
Observational-Dx |
64 patients |
To investigate whether cervical sonoelastography improves prediction of spontaneous preterm birth compared with cervical length measurement and a fetal fibronectin (fFN) test. |
Cervical sonoelastography and fFN test show a significant correlation with spontaneous preterm delivery (P = 0.007, P = 0.001), resulting in 72.7%/36% sensitivity and 73%/95% specificity. The positive predictive value (PPV) was 61.5%/81.8% and the negative predictive value was 81.8%/70%. The cervical length was not different in cases with and without term delivery (P = 0.165). |
2 |
| 23. American College of Radiology. ACR-ACOG-AIUM-SMFM-SRU Practice Parameter for the Performance of Standard Diagnostic Obstetrical Ultrasound. Available at: https://www.acr.org/-/media/ACR/Files/Practice-Parameters/us-ob.pdf |
Review/Other-Dx |
N/A |
To promote the safe and effective use of diagnostic and therapeutic radiology by describing the key elements of standard ultrasound examinations in the first, second, and third trimesters of pregnancy. |
No abstract available. |
4 |
| 24. Friedman AM, Srinivas SK, Parry S, Elovitz MA, Wang E, Schwartz N. Can transabdominal ultrasound be used as a screening test for short cervical length?. Am J Obstet Gynecol. 208(3):190.e1-7, 2013 Mar. |
Observational-Dx |
1217 women |
To determine whether transabdominal ultrasound be used as a screening test for short cervical length. |
Prevoid transabdominal cervical length |
2 |
| 25. Pandipati S, Combs CA, Fishman A, Lee SY, Mallory K, Ianovich F. Prospective evaluation of a protocol for using transabdominal ultrasound to screen for short cervix. Am J Obstet Gynecol. 213(1):99.e1-13, 2015 Jul. |
Observational-Dx |
1580 women |
To evaluate a recently proposed protocol whereby transabdominal ultrasound of the cervix might be used as a prescreen to select women to undergo or to forgo measurement of cervical length via transvaginal ultrasound (CLvag). |
An interim analysis identified several technical problems with CLabd measurements, so the protocol was extensively revised. Under the revised protocol, 1580 women were included. Adequate views of the cervix were obtained via transabdominal imaging in 46% of subjects with the bladder empty and 56% with the bladder full. The correlation between CLabd and CLvag was poor (r = 0.38). Of the 17 patients with a short cervix, 15 had suboptimal transabdominal exams (screen positive) and 2 had CLabd<=35 mm with bladder empty (screen positive). Sensitivity of the screen was 100% (95% confidence interval, 80.5-100%) but specificity was only 32.2% (95% confidence interval, 29.9-34.6%) and screen positive rate was 66.3%. Several technical problems and limitations of transabdominal imaging of the cervix are shown. |
3 |
| 26. Cicero S, Skentou C, Souka A, To MS, Nicolaides KH. Cervical length at 22-24 weeks of gestation: comparison of transvaginal and transperineal-translabial ultrasonography. Ultrasound Obstet Gynecol. 2001; 17(4):335-340. |
Observational-Dx |
500 patients |
To investigate the feasibility of measuring cervical length by transperineal or translabial sonography and compare the measurements obtained by this approach with those obtained transvaginally. |
Cervical length was successfully measured transvaginally in all cases. In the first phase of the study cervical length was measured by translabial-transperineal sonography in 84% of the 200 patients but there was poor agreement with measurements obtained transvaginally and the 95% tolerance interval for paired observations was -11.0 mm to 16.1 mm. After audit of results it became apparent that the translabially-transperineally derived images were inadequate in more than half of the cases but in those with adequate paired measurements there was a very good agreement between the two and the 95% tolerance interval for paired observations was -5.8 mm to 5.2 mm. In the second phase of the study special attention was paid towards recording measurements of cervical length only in cases where both the internal and external os were adequately visualized. Successful measurements by translabial-transperineal sonography were obtained in 78% of cases and the 95% tolerance interval for paired observations was -5.8 mm to 6.1 mm. The degree of patient acceptability of the two methods was similar. |
3 |
| 27. Ozdemir I, Demirci F, Yucel O. Transperineal versus transvaginal ultrasonographic evaluation of the cervix at each trimester in normal pregnant women. Aust N Z J Obstet Gynaecol. 45(3):191-4, 2005 Jun. |
Observational-Dx |
104 women |
To compare transvaginal and transperineal ultrasonography in the assessment of cervical length and cervicalchanges in normal gravid patients at each trimester. |
Cervical length measurements were obtained by transvaginal ultrasonography in all 104 patients and bytransperineal ultrasonography in 101 patients (97.1%) (P = 0.1). By gestational age, the greatest length discrepancy(2.8 mm) between the two ultrasonographic methods was found at 10–14 weeks (P < 0.001). At 20–24 and 30–34weeks’ gestation, the mean length differences were less than 1 mm (P < 0.01 and P = 0.337, respectively). Cervicalfunnelling was observed in 16 patients by both methods, whereas in two patients from the 20–24 week gestationalage group, funnelling was observed by transvaginal ultrasonography and not by transperineal ultrasonography. |
3 |
| 28. Hertzberg BS, Livingston E, DeLong DM, McNally PJ, Fazekas CK, Kliewer MA. Ultrasonographic evaluation of the cervix: transperineal versus endovaginal imaging. J Ultrasound Med. 2001;20(10):1071-1078; quiz 1080. |
Observational-Dx |
64 pregnant women |
To compare transperineal and endovaginal ultrasonography of the gravid cervix to evaluate image quality and assess for a systematic difference in cervical lengths measured by the 2 techniques. |
There was a strong reviewer preference for endovaginal ultrasonographic images over transperineal images for both assessing the cervix (P< .001) and evaluating for placenta previa (P< .001). Despite this, transperineal and endovaginal ultrasonographic images were frequently rated as similar in diagnostic quality by both reviewers for depicting the cervix (35.9% of patients) and evaluating for placenta previa (57.8% of patients). The mean length of the cervix was slightly shorter at transperineal ultrasonography (28.4 mm) than at endovaginal ultrasonography (30.1 mm). When cervical lengths were subdivided by gestational age, however, a significant length discrepancy was found only in the 14- to 20-week gestational age range. In this age range, mean cervical length at transperineal ultrasonography (28.6 mm) averaged 5.5 mm less than at endovaginal ultrasonography (34.1 mm). |
2 |
| 29. Son M, Grobman WA, Ayala NK, Miller ES. A universal mid-trimester transvaginal cervical length screening program and its associated reduced preterm birth rate. Am J Obstet Gynecol. 214(3):365.e1-5, 2016 Mar. |
Observational-Dx |
64,207 women |
To examine whether the introduction of a universal transvaginal cervical length screening program is associated with a reduction in the preterm birth rate. |
Of 64,207 eligible women, 46,598 underwent their midtrimester sonogram before the universal cervical length screening program, and 17,609 underwent a sonogram after implementation of the program. Of the 17,590 women (99.9%) who agreed to cervical length measurement, 157 (0.89%) had a measurement of 25 mm. The introduction of the cervical length program was associated with a significant decrease in the frequency of preterm birth at <37 weeks of gestation (6.7% vs 6.0%; adjusted odds ratio, 0.82 [95% confidence interval, 0.76e0.88]), <34 weeks of gestation (1.9% vs 1.7%; adjusted odds ratio, 0.74 [95% confidence interval, 0.64-0.85]), and <32 weeks of gestation (1.1% vs 1.0%; adjusted odds ratio, 0.74 (95% confidence interval, 0.62-0.90]). This reduction in frequency of preterm birth primarily was due to a change in spontaneous (and not medically indicated) preterm births. The effect size for the reduction in preterm birth was similar in nulliparous and multiparous women with previous term births. |
3 |
| 30. Temming LA, Durst JK, Tuuli MG, et al. Universal cervical length screening: implementation and outcomes. Am J Obstet Gynecol. 214(4):523.e1-8, 2016 Apr. |
Observational-Dx |
12,740 women |
To evaluate the acceptability of a universal cervical length screening program. |
Of 12,740 women undergoing anatomic survey during the study period, 10,871 (85.3%, 95% CI 84.7%, 85.9%) underwent cervical length screening. Of those, 215 (2.0%) had a cervical length =25 millimeters and 131 (1.2%) had a cervical length =20 millimeters. After the first six months of implementation, there was no change in rates of acceptance of cervical length screening over time (p for trend=0.15). Women were more likely to decline cervical length screening if they were African American (aOR 2.17 95% CI 1.93,2.44), obese (aOR 1.18, 95% CI 1.06,1.31), multiparous (aOR 1.45, 95% CI 1.29,1.64), younger than 35 years (aOR 1.24, 95% CI 1.08,1.43), or smoked (aOR 1.42, 95% CI 1.20,1.68). Rates of spontaneous preterm birth before 28 weeks were higher in those who declined cervical length screening (aOR 2.01, 95% CI 1.33, 3.02). |
3 |
| 31. Orzechowski KM, Boelig RC, Baxter JK, Berghella V. A universal transvaginal cervical length screening program for preterm birth prevention. Obstet Gynecol. 124(3):520-5, 2014 Sep. |
Observational-Dx |
2171 women |
To evaluate a universal transvaginal ultrasonogram cervical length screening program on the incidence of a cervical length 20 mm or less and adherence to the management protocol for a cervical length less than 25 mm. |
One thousand five hundred sixty-nine of 2,171 (72.3%) eligible women underwent transvaginal ultrasonogram cervical length screening. Overall, 17 (1.1%, 95% confidence interval [CI] 0.66–1.74) women had a cervical length 20 mm or less before 24 weeks of gestation. Management protocol deviations occurred in nine women with a cervical length less than 25 mm (43%, 95% CI 24.3–63.5). There was no difference in the incidence of spontaneous preterm birth at less than 37 weeks of gestation (4.1 compared with 4.7%, adjusted odds ratio [OR] 0.91, 95% CI 0.57–1.45), less than 34 weeks of gestation (1.5 compared with 1.3%, adjusted OR 1.19, 95% CI 0.52–2.74), or less than 32 weeks of gestation (0.8 compared with 0.8%, adjusted OR 0.0.76, 95% CI 0.26–2.25) among women receiving transvaginal ultrasonogram cervical length screening compared with those not screened. |
3 |
| 32. Esplin MS, Elovitz MA, Iams JD, et al. Predictive Accuracy of Serial Transvaginal Cervical Lengths and Quantitative Vaginal Fetal Fibronectin Levels for Spontaneous Preterm Birth Among Nulliparous Women. JAMA. 317(10):1047-1056, 2017 03 14. |
Observational-Dx |
9410 women |
To assess the accuracy of universal screening to predict spontaneous preterm birth in nulliparous women using serial measurements of vaginal fetal fibronectin levels and cervical length. |
The study included 9410 women (median age, 27.0 [interquartile range, 9.0] years; 60.7% non-Hispanic white, 13.8% non-Hispanic black, 16.5% Hispanic, 4.0% Asian, and 5.1% other), of whom 474 (5.0%) had spontaneous preterm births, 335 (3.6%) had medically indicated preterm births, and 8601 (91.4%) had term births. Among women with spontaneous preterm birth, cervical length of 25 mm or less occurred in 35 of 439 (8.0%) at 16 to 22 weeks’ gestation and in 94 of 403 (23.3%) at 22 to 30 weeks’ gestation. Fetal fibronectin levels of 50 ng/mL or greater at 16 to 22 weeks identified 30 of 410 women (7.3%) with spontaneous preterm birth and 31 of 384 (8.1%) at 22 to 30 weeks. The area under the receiver operating characteristic curve for screening between 22 and 30 weeks for fetal fibronectin level alone was 0.59 (95% CI, 0.56–0.62), for transvaginal cervical length alone was 0.67 (95% CI, 0.64–0.70), and for the combination as continuous variables was 0.67 (95% CI, 0.64–0.70). |
2 |
| 33. Timor-Tritsch IE, Yunis RA. Confirming the safety of transvaginal sonography in patients suspected of placenta previa. Obstet Gynecol. 81(5 ( Pt 1)):742-4, 1993 May. |
Observational-Dx |
18 patients |
To evaluate the safety of transvaginal ultrasonography in the diagnosis of placenta previa by determining whether the angle between the cervix and the vaginal probe is sufficient for alignment of the probe with the cervix. |
The mean angles were 63.8 degrees and 67.5 degrees, with minimum angles of 44 degrees and 48 degrees for the placenta previa and control groups, respectively. The values were not statistically different. |
4 |
| 34. Friedman AM, Schwartz N, Ludmir J, Parry S, Bastek JA, Sehdev HM. Can transabdominal ultrasound identify women at high risk for short cervical length?. Acta Obstet Gynecol Scand. 92(6):637-41, 2013 Jun. |
Observational-Dx |
703 patients |
To determine whether transabdominal cervical length screening could identify women at high risk for having a short cervix on transvaginal ultrasound. |
In all, 703 patients were included in the primary analysis; 3.42 women with transabdominal cervical length <=30 mm needed to undergo transvaginal ultrasound to detect one woman with transvaginal ultrasound cervical length <=20 mm. Of women with short transvaginal cervical length <=20 mm, 89.8% had a transabdominal measurement <=30 mm and 96.7% had a transabdominal measurement <=33 mm. |
3 |
| 35. Marren AJ, Mogra R, Pedersen LH, Walter M, Ogle RF, Hyett JA. Ultrasound assessment of cervical length at 18-21 weeks' gestation in an Australian obstetric population: comparison of transabdominal and transvaginal approaches. Aust N Z J Obstet Gynaecol. 54(3):250-5, 2014 Jun. |
Observational-Dx |
198 women |
To determine whether a policy of reverting to transvaginal cervical assessment only if the cervix appears short (=25 mm) on transabdominal assessment affects the efficiency of screening. |
One hundred and ninety-eight women agreed to participate in the study. Identification of the internal and external cervical os was possible during TABF, TABE and TV sonography in 97.0, 82.8 and 100%, respectively. Compared with TV sonography, TABF overestimates cervical length (6.1 mm difference in median values; P < 0.01). There was no significant difference between TV and TABE. However, TABE assessment was not possible in one in six women. If TABF sonography was to be used as a screening tool and using =25 mm as the critical cut-off, the sensitivity and specificity was 15.4 and 93.2%, respectively. |
3 |
| 36. Committee on Practice Bulletins-Obstetrics, The American College of Obstetricians Gynecologists. Practice bulletin no. 130: prediction and prevention of preterm birth. Obstet Gynecol 2012;120:964-73. |
Review/Other-Dx |
N/A |
Practice guideline on prediction and prevention of preterm birth. |
N/A |
4 |
| 37. McIntosh J, Feltovich H, Berghella V, Manuck T. The role of routine cervical length screening in selected high- and low-risk women for preterm birth prevention. Am J Obstet Gynecol 2016;215:B2-7. |
Review/Other-Dx |
N/A |
To review the indications and rationale for cervical length screening to prevent preterm birth in various clinical scenarios. |
No results stated in abstract. |
4 |
| 38. Sim S, Da Silva Costa F, Araujo Junior E, Sheehan PM. Factors associated with spontaneous preterm birth risk assessed by transvaginal ultrasound following cervical cerclage. Aust N Z J Obstet Gynaecol. 55(4):344-9, 2015 Aug. |
Observational-Dx |
59 female patients |
To determine the predictive value of various cervical length measurements postcerclage for the outcome of preterm birth following both elective and rescue cerclage. |
There was a strong correlation between cervical length postcerclage and gestation at delivery. For both groups, preterm birth could be predicted by the total cervical length. In the rescue cerclage group, the change in cervical length was predictive, with positive changes associated with later gestation at delivery. The presence of funnelling was predictive of preterm birth in the elective cerclage group only. |
4 |
| 39. Miller ES, Gerber SE. Association between sonographic cervical appearance and preterm delivery after a history-indicated cerclage. J Ultrasound Med. 33(12):2181-6, 2014 Dec. |
Observational-Dx |
124 women |
To determine which transvaginal cervical sonographic characteristics are associated with preterm delivery after placement of a history-indicated cerclage. |
A total of 124 women met inclusion criteria, with 17 (14%) delivering before 34 weeks. Cervical funneling, a proximal cervical length of less than 1.5 cm, and a total cervical length of less than 2.5 cm were associated with an increased odds of preterm birth before 34 weeks in the bivariable analysis [odds ratio (OR), 10.9 (95% confidence interval (CI), 2.3-62.8), 2.9 (95% CI, 1.0-8.5), and 4.5 (95% CI, 1.3-16.4), respectively], whereas distal cervical length of less than 1 cm was not significantly associated with delivery before 34 weeks [OR, 3.0 (95% CI, 0.8-11.1)]. In multivariable analysis, only cervical funneling remained associated with preterm delivery before 34 weeks [adjusted OR, 10.6 (95% CI, 2.2-51.5)]. |
4 |
| 40. Gauthier T, Marin B, Garuchet-Bigot A, et al. Transperineal versus transvaginal ultrasound cervical length measurement and preterm labor. Arch Gynecol Obstet. 290(3):465-9, 2014 Sep. |
Observational-Dx |
62 patients |
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. |
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. |
2 |
| 41. Dimassi K, Hammami A, Bennani S, Halouani A, Triki A, Gara MF. Use of transperineal sonography during preterm labor. J Obstet Gynaecol. 36(6):748-753, 2016 Aug. |
Observational-Dx |
60 patients |
1. To investigate the reliability of Transperineal ultrasound scan (TPUS) performed by obstetrical team on duty in case of preterm labour (PL) and tocompare transperineal to transvaginal cervical length (CL) measurements as a reference.2. To assess the predictive value of transperineal CL measurement for preterm delivery (PD). |
Sixty patients admitted with PL were included. Median CL measurements with TPUS and TVUS were 25.3mm and 27.3 mm, respectively. Correlation was significant (R =0.95; p<0.0001; [95% CI=(-0.032–0.170)]. The cut-off point was 25mm for TPUS and 22.8mm for TVUS. In case of PL, CL measurement with TPUS seems reliable and can be performed by the obstetric duty team. |
2 |
| 42. Gomez R, Romero R, Nien JK, et al. A short cervix in women with preterm labor and intact membranes: a risk factor for microbial invasion of the amniotic cavity. Am J Obstet Gynecol. 2005;192(3):678-689. |
Observational-Dx |
401 patients |
To determine whether there was a relationship between sonographic cervical length and the presence of culture-proven MIAC in women with preterm labor and intact membranes. Patients were selected from a prospective cohort study. |
The prevalence of MIAC was 7% (28/401). Spontaneous preterm delivery (=35 weeks) occurred in 21.4% (82/384) of patients. ROC curve analysis showed a significant relationship between the frequency of MIAC and the length of the uterine cervix (area under the curve: 0.77; P<.005). Patients with a cervical length <15 mm had a higher rate of a positive amniotic fluid culture than patients with a cervical length =15 mm (26.3% [15/57] vs 3.8% [13/344], respectively; P<.05). Moreover, patients with a short cervix (defined as <15 mm) were more likely to deliver spontaneously before 35 weeks, 32 weeks, within 7 days, and within 48 hours of admission ( P<.05 for all comparisons). 40% of patients (161/401) had a cervical length =30 mm. These patients had a very low risk of MIAC (1.9% [3/161]), spontaneous delivery =35 weeks (4.5% [7/154]), =32 weeks (2.6% [2/76]), within 7 days (1.9% [3/154]), and within 48 hours (0% [0/154]) of admission. Endovaginal US examination of the uterine cervix in women with preterm labor identifies patients at increased risk for intrauterine infection. |
3 |
| 43. Maia MC, Nomura R, Mendonca F, Rios L, Moron A. Is cervical length evaluated by transvaginal ultrasonography helpful in detecting true preterm labor?. J Matern Fetal Neonatal Med. 1-7, 2019 Jan 22. |
Observational-Dx |
126 patients with preterm labor |
To investigate whether sonographic cervical markers can identify women in true preterm labor and predict delivery within 7 d and before 34 or 37 gestational weeks. |
The inclusion criteria were met by 126 women, 31 (25%) of whom were excluded and 95 were analyzed. The median gestational age at admission was 31.9weeks. The median CL at preterm labor was 22.3mm (range: 0–42.8 mm). The delivery occurred within 7 d of presentation in 13 (13.7%) cases. Delivery before 34 weeks occurred in 16 (16.8%) cases and before 37weeks in 40 (42.1%) cases. Logistic regression analysis showed CL in millimeters was an independent predictor of delivery within 7 d (OR 0.918, 95% CI 0.862–0.978, p=.008). For birth before 34 weeks, the predictor was gestational age at admission (OR 0.683, 95% CI 0.539 0.866, p=.002) and before 37weeks, the presence of cervical funneling (OR 3.778, 95% CI 1.460–9.773, p=.006). The CL15mm had sensitivity and specificity values of 77 and 77%, respectively, and good accuracy (88%) for prediction of delivery within 7 d. |
3 |
| 44. Melamed N, Hiersch L, Domniz N, Maresky A, Bardin R, Yogev Y. Predictive value of cervical length in women with threatened preterm labor. Obstet Gynecol. 122(6):1279-87, 2013 Dec. |
Observational-Dx |
1077 women |
To assess the predictive role of ultrasonographic cervical length for preterm delivery in women with threatened preterm labor. |
Between 2007 and 2012, 1,077 women presented with preterm labor and met the study criteria. The correlation between cervical length and the time interval to delivery was significant but weak (r=0.293, P<.001). Cervical length was independently associated with the risk of preterm delivery at less than 37, 35, and 32 weeks of gestation and within 14 and 7 days from presentation (a 4–7% decrease in the risk for each additional millimeter of cervical length) as well as with the time interval between presentation and delivery (each additional 2 mm was associated with an increase of 1 day). Overall, the accuracy of cervical length in predicting preterm delivery was relatively poor. |
3 |
| 45. Hiersch L, Melamed N, Aviram A, Bardin R, Yogev Y, Ashwal E. Role of Cervical Length Measurement for Preterm Delivery Prediction in Women With Threatened Preterm Labor and Cervical Dilatation. J Ultrasound Med. 35(12):2631-2640, 2016 Dec. |
Observational-Dx |
1068 women |
To compare the accuracy and cutoff points for cervical length for predicting preterm delivery in women with threatened preterm labor between those with a closed cervix and cervical dilatation. |
Overall, 1068 women with threatened preterm labor met the inclusion criteria; of them, 276 (25.8%) had cervical dilatation, and 792 (74.2%) had a closed cervix. The risk of preterm delivery before 37 weeks was significantly higher in the cervical dilatation group than the closed cervix group, as well as a shorter assessment-to- delivery interval of within 14 days (P = .001 and .004, respectively). On a multivariable analysis, cervical length was independently associated with the risk of preterm delivery in both groups. There was no significant difference between women with cervical dilatation and those with a closed cervix regarding the area under the receiver operating characteristic curves of cervical length for prediction of preterm delivery before 37 (0.674 versus 0.618; P = .18) and 34 (0.628 versus 0.640; P = .88) weeks and an assessment-to-delivery interval of 14 days (0.686 versus 0.660; P= .72). The negative predictive value of cervical length ranged from 77.4% to 95.7% depending on the different thresholds used. |
3 |
| 46. Hassan WA, Eggebo TM, Ferguson M, Lees C. Simple two-dimensional ultrasound technique to assess intrapartum cervical dilatation: a pilot study. Ultrasound Obstet Gynecol. 41(4):413-8, 2013 Apr. |
Observational-Dx |
21 women |
To describe a two-dimensional (2D) ultrasound technique to measure cervical dilatation in labor, and to compare ultrasound with digital measurements. |
Satisfactory quality images of the cervix were obtained in 19 of 21 cases. There was positive correlation between 2D ultrasound measurement of cervical dilatation and digital vaginal examination (Pearson coefficient r=0.821, n=19, P<0.001). Bland–Altman analysis showed a mean difference between digital and ultrasound measurements of 0.08 cm (95% limits of agreement: -1.83 to 2.00) and the mean absolute difference was 1.24 cm. The ICC between the two methods was 0.81 (95% CI, 0.58–0.92). |
2 |
| 47. Benediktsdottir S, Eggebo TM, Salvesen KA. Agreement between transperineal ultrasound measurements and digital examinations of cervical dilatation during labor. BMC Pregnancy Childbirth. 15:273, 2015 Oct 24. |
Observational-Dx |
86 women |
To compare 2D transperineal ultrasound assessment of cervical dilatation with vaginal examination and to investigate intra-observer variability of the ultrasound method. |
Cervical dilatation was successfully assessed with ultrasound in 61/86 (71 %) women. The mean difference between cervical dilatation and ultrasound measurement was 0.9 cm (95 % CI 0.47+–1.34). Interclass correlation coefficient (ICC) was 0.83 (95 % CI 0.72+–0.90). Intra-observer repeatability was analysed in 26 women. The intra-observer ICC was 0.99 (95 % CI 0.97+–0.99). The repeatability coefficient was ± 0.68 (95 % CI 0.45+–0.91). |
1 |
| 48. Yuce T, Kalafat E, Koc A. Transperineal ultrasonography for labor management: accuracy and reliability. Acta Obstet Gynecol Scand. 94(7):760-5, 2015 Jul. |
Observational-Dx |
43 women |
To compare ultrasound measurements and clinical assessments of cervical dilatation, fetal head station and fetal head position. |
Ultrasonographic assessment of dilatation correlated significantly with digital examination. The interclass correlation coefficientof the two methods was 0.82 (95% confidence interval 0.73–0.88). Ultrasonography showed a mean lower cervical dilatation of 10 mm (95%limits of agreement: -36 to 16 mm) compared with digital examination. The angle of progression and head–perineum distances correlated moderately withthe palpated head station (Pearson’s correlation coefficients: 0.55 and -0.42, respectively; p < 0.001). Position could only be assessed in 40 of 79 examinationsby digital examinations and the results showed low agreement with ultrasound findings. |
1 |
| 49. Verhoeven CJ, Opmeer BC, Oei SG, Latour V, van der Post JA, Mol BW. Transvaginal sonographic assessment of cervical length and wedging for predicting outcome of labor induction at term: a systematic review and meta-analysis. [Review]. Ultrasound Obstet Gynecol. 42(5):500-8, 2013 Nov. |
Meta-analysis |
31 studies |
To perform a systematic review and metaanalysis to assess the predictive capacity of transvaginal sonographic assessment of the cervix for the outcome of induction of labor. |
We included 31 studies reporting on both cervical length and outcome of delivery. The quality of the included studies was mediocre. Sensitivity of cervical length in the prediction of Cesarean delivery ranged from 0.14 to 0.92 and specificity ranged from 0.35 to 1.00. The estimated sROC curve for cervical length indicated a limited predictive capacity in the prediction of Cesarean delivery. Summary estimates of sensitivity/specificity combinations of cervical length at different cut-offs for Cesarean delivery were 0.82/0.34, 0.64/0.74 and 0.13/0.95 for 20, 30 and 40 mm, respectively. For cervical wedging in the prediction of failed induction of labor summary point estimates of sensitivity/specificity were 0.37/0.80. |
Good |
| 50. Brik M, Mateos S, Fernandez-Buhigas I, Garbayo P, Costa G, Santacruz B. Sonographical predictive markers of failure of induction of labour in term pregnancy. J Obstet Gynaecol. 37(2):179-184, 2017 Feb. |
Observational-Dx |
245 women |
1. To evaluate predictive markers of failure of induction of labour in term pregnancy, 2. To evaluate predictive markers of induction to delivery interval and mode of delivery. |
Women with a longer cervical length prior to induction (CLpi) had a higher rate of failure of induction (30.9 ± 6.8 vs. 23.9 ± 9.3, p<.001). BMI was higherand maternal height was lower in the group of caesarean section compared to vaginal delivery (33.1 ± 8 vs. 29.3 ± 4.6, 160 ± 5 vs. 164 ± 5, p<.001, respectively). A shorter CLpi correlated with a shorter induction to delivery interval (R Pearson .237, p<.001). In the regression analysis, for failure of induction the only independent predictor was the CL prior to induction. |
2 |
| 51. Pereira S, Frick AP, Poon LC, Zamprakou A, Nicolaides KH. Successful induction of labor: prediction by preinduction cervical length, angle of progression and cervical elastography. Ultrasound Obstet Gynecol. 44(4):468-75, 2014 Oct. |
Observational-Dx |
99 women |
To examine the potential value of preinduction cervical length, cervical elastography and angle of progression (AOP) in prediction of successful vaginal delivery and induction-to-delivery interval. |
Vaginal delivery occurred in 66 (66.7%) cases and Cesarean delivery was performed in 33 (33.3%) cases. There were significant correlations between cervical length and both AOP (r=-0.319) and elastographic score (r= 0.368). Significant independent prediction of vaginal delivery and induction-to-delivery interval was provided by nulliparity and cervical length, with no additional significant contribution from electrographic score or AOP. |
2 |
| 52. Prado CA, Araujo Junior E, Duarte G, et al. Predicting success of labor induction in singleton term pregnancies by combining maternal and ultrasound variables. J Matern Fetal Neonatal Med. 29(21):3511-8, 2016 Nov. |
Observational-Dx |
204 women |
To assess pre-induction maternal and ultrasonographic factors in the prediction of the onset of labor within 12 h, and vaginal delivery (VD) irrespective of the induction-to-delivery interval in term pregnancies. |
VD occurred in 116 (56.9%) women. Prediction of the onset of labor within 12 h was provided by the BMI and resistance index of the fetal middle cerebral artery. Prediction of the VD irrespective of the induction-to-delivery interval was provided by height, BMI, parity, number of prenatal visits, consistency, effacement and dilation of uterine cervix, PCA, oligohydramnios, HC and EFW. Area under ROC curve for PCA and EFW were 63.5 (sensibility: 66.4%, specificity: 59.1%) and 60.2 (sensibility: 54.3%, specificity: 70.4%), respectively. |
2 |
| 53. Ezebialu IU, Eke AC, Eleje GU, Nwachukwu CE. Methods for assessing pre-induction cervical ripening. [Review]. Cochrane Database Syst Rev. (6)CD010762, 2015 Jun 12. |
Review/Other-Dx |
2 trials, 234 women |
To compare Bishop score with any other method for assessing pre-induction cervical ripening in women admitted for induction oflabour. |
We included two trials that recruited a total of 234 women. The overall risk of bias was low for the two studies. Both studies comparedBishop score withTVUS.The two included studies did not show any clear difference between the Bishop score and TVUS groups for the following mainoutcomes: vaginal birth (RR 1.07, 95% CI 0.92 to 1.25, moderate quality evidence), caesarean delivery (RR 0.81, 95% CI 0.49 to1.34, moderate quality evidence), neonatal admission into neonatal intensive care unit (RR 1.67, 95% CI 0.41 to 6.71, moderate qualityevidence). Both studies only provided median data in relation to induction-delivery interval and reported no clear difference betweenthe Bishop and TVUS groups. Perinatal mortality was not reported in the included studies.For the review’s secondary outcomes, the need for misoprostol for cervical ripening was more frequent in the TVUS group comparedto the Bishop score group (RR 0.52, 95% CI 0.41 to 0.66, two studies, 234 women, moderate quality evidence). In contrast, there wereno clear differences between the Bishop scope and TVUS groups in terms of meconium staining of the amniotic fluid, fetal heart rateabnormality in labour, and Apgar score less than seven. Only one trial reported median data on the induction-delivery interval andinduction to active phase interval, the trialist reported no difference between the Bishop group and the TVUS group for this outcome.Neither of the included studies reported on uterine rupture. |
4 |
| 54. Kunzier NB, Kinzler WL, Chavez MR, Adams TM, Brand DA, Vintzileos AM. The use of cervical sonography to differentiate true from false labor in term patients presenting for labor check. Am J Obstet Gynecol. 215(3):372.e1-5, 2016 Sep. |
Observational-Dx |
77 patients |
To determine if cervical length by transvaginal ultrasound can differentiate true from false labor in term patients presenting for labor check. |
In all, 77 patients were included in the study; the prevalence of true labor was 58.4% (45/77). Patients who were in true labor had shorter cervical length as compared to those in false labor: median 1.3 cm (range 0.5-4.1) vs 2.4 cm (range 1.0-5.0), respectively (P < .001). The area under the receiver operating characteristic curve for primiparous patients was 0.88 (P < .001) and for multiparous patients was 0.76 (P < .01), both demonstrating good correlation. The area under the receiver operating characteristic curves were not significantly different between primiparous and multiparous (P = .23). The area under the receiver operating characteristic curve for primiparous and multiparous patients combined was 0.8 (P < .0001), indicating a good overall correlation between cervical length and its ability to differentiate true from false labor. Overall, a cervical length cutoff of <=1.5 cm to predict true labor had the highest specificity (81%), positive predictive value (83%), and positive likelihood ratio (4.2). There were no differences in cervical length prediction between primiparous and multiparous patients. Cervical length was positively correlated with time to delivery, regardless of the use of oxytocin. |
2 |
| 55. American College of Radiology. ACR–SPR Practice Parameter for the Safe and Optimal Performance of Fetal Magnetic Resonance Imaging (MRI). Available at: https://www.acr.org/-/media/ACR/Files/Practice-Parameters/mr-fetal.pdf |
Review/Other-Dx |
N/A |
To promote safe and optimal performance of fetal magnetic resonance imaging (MRI). |
No abstract available. |
4 |
| 56. American College of Radiology. ACR-SPR Practice Parameter for Imaging Pregnant or Potentially Pregnant Patients with Ionizing Radiation. Available at: http://www.acr.org/~/media/ACR/Documents/PGTS/guidelines/Pregnant_Patients.pdf. |
Review/Other-Dx |
N/A |
To assist practitioners in providing appropriate radiologic care for pregnant or potentially pregnant adolescents and women by describing specific training, skills and techniques. |
No abstract available. |
4 |
| 57. American College of Radiology. Manual on Contrast Media. Available at: https://www.acr.org/Clinical-Resources/Contrast-Manual. |
Review/Other-Dx |
N/A |
To assist radiologists in recognizing and managing risks associated with the use of contrast media. |
No abstract available. |
4 |
| 58. Expert Panel on MR Safety, Kanal E, Barkovich AJ, et al. ACR guidance document on MR safe practices: 2013. J Magn Reson Imaging. 37(3):501-30, 2013 Mar. |
Review/Other-Dx |
N/A |
To help guide MR practitioners regarding MR safety issues and provide a basis for them to develop and implement their own MR policies and practices. |
No abstract available. |
4 |
| 59. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://www.acr.org/-/media/ACR/Files/Appropriateness-Criteria/RadiationDoseAssessmentIntro.pdf. |
Review/Other-Dx |
N/A |
To provide evidence-based guidelines on exposure of patients to ionizing radiation. |
No abstract available. |
4 |
