1
|
Kamel R, Garcia FSM, Poon LC, Youssef A. The usefulness of ultrasound before induction of labor. Am J Obstet Gynecol MFM 2021; 3:100423. [PMID: 34129996 DOI: 10.1016/j.ajogmf.2021.100423] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/19/2021] [Accepted: 05/26/2021] [Indexed: 12/13/2022]
Abstract
The indications for induction of labor have been consistently on the rise. These indications are mainly medical (maternal or fetal) or social or related to convenience or maternal preferences. With the increase in the prevalence of these indications, the incidence rates of induction of labor are expected to rise continuously. This poses a substantial workload and financial burden on maternity healthcare systems. Failure rates of induction of labor are relatively high, especially when considering the maternal, fetal, and neonatal risks associated with emergency cesarean deliveries in cases of failure. Therefore, it is essential for obstetricians to carefully select women who are eligible for induction of labor, particularly those with no clinical contraindication and who have a reasonable chance of ending up with a successful noncomplicated vaginal delivery. Ultrasound has an established role in the various areas of obstetrical care. It is available, accessible, easy to perform, and acceptable to the patient. In addition, the learning curve for skillful obstetrical ultrasound scanning is rather easy to fulfill. Ultrasound has always had an important role in the assessment of maternal and fetal well-being. Indeed, it has been extensively explored as a reliable, reproducible, and objective tool in the management of labor. In this review, we aimed to provide a comprehensive update on the different applications and uses of ultrasound before induction of labor for the prediction of its success and the potential improvement of its health-related maternal and fetal outcomes.
Collapse
Affiliation(s)
- Rasha Kamel
- Maternal-Fetal Medicine Unit, Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt (Dr Kamel).
| | - Francisca S Molina Garcia
- Department of Obstetrics and Gynecology, Hospital Clínico San Cecilio, Instituto de Investigación Biosanitaria IBS, Granada, Spain (Dr Molina Garcia)
| | - Liona C Poon
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, China (Dr Poon)
| | - Aly Youssef
- Obstetric Unit, Department of Medical and Surgical Sciences, University of Bologna and IRCCS Azienda Ospedaliero-Universitaria S.Orsola-Malpighi, Bologna, Italy (Dr Youssef)
| |
Collapse
|
2
|
Chan YTV, Lau KW, Hui W, Lau CH, Leung WC, Lau WL. Sonographic measurement of cervical length and head perineum distance before labor to predict time of delivery. J Matern Fetal Neonatal Med 2021; 35:4905-4909. [PMID: 33455498 DOI: 10.1080/14767058.2021.1873264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This was an observational study on cervical length and head perineum distance and the prediction of time of delivery. One-hundred and twenty-five nulliparous women with uncomplicated, term, singleton pregnancy were recruited when they presented to the labor ward with show or infrequent painful uterine contractions (less than three contractions in ten minutes on a 30 min cardiotocogram). Apart from digital vaginal examination to assess cervical length and dilatation, sonographic cervical length and head perineum distance were measured by two-dimensional ultrasound. We compared women who delivered within 72 h of presentation of labor symptoms, with women who did not. After excluding ten women whose labor was induced and delivered within 72 h of presentation, one hundred and fifteen women were included for final data analysis. MAIN FINDINGS Forty-nine women (42.6%) delivered while sixty-six women (57.4%) remained undelivered at 72 h of presentation of symptoms of labor. There was no statistically significant difference between the two groups on age, presence of show, contractions, fetal head station and presentation and mode of delivery. For the group who had delivered within 72 h of presentation of labor symptoms, the mean sonographic cervical length was 1.87 cm ± 0.62 cm, while the head perineum distance was 6.01 cm ± 1.15 cm. For the other group, the mean sonographic cervical length was 2.10 cm ± 0.83 cm; head perineum distance was 6.03 cm ± 1.18 cm. There was no statistically significant difference between the groups for both sonographic cervical length (p = .90); and head perineum distance (p = .08). We also compared the cervical length measured by digital vaginal examination versus sonography. The median sonographic measurements were 1.47 cm, 2.11 cm and 2.79 cm at "1 cm," "2 cm" and "3 cm" digital vaginal measurement, respectively. However, there was extensive overlap between digitally and sonographically measured cervical length. Prediction accuracy of cervical length and head perineum distance was poor. The area under curve (AUC) of receiver operating characteristic (ROC) curve were 0.433 for sonographic cervical length and 0.501 for HPD. CONCLUSION Transperineal sonographical assessment of cervical length and head perineum distance before labor was not useful in predicting the time of delivery. However, it can be explored as an alternative assessment method when digital vaginal examination is not preferred.
Collapse
Affiliation(s)
- Ying Tze Viola Chan
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Kowloon, China
| | - Ka Wing Lau
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Kowloon, China
| | - Winnie Hui
- Department of Obstetrics and Gynaecology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, China
| | - Chin Ho Lau
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Kowloon, China
| | - Wing Cheong Leung
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Kowloon, China
| | - Wai Lam Lau
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Kowloon, China
| |
Collapse
|
3
|
Li X, Li L, Li Y, Fang S, Zhao C, Zhang Y, Yang Z. USEFULNESS OF TRANSPERINEAL VIRTUAL TOUCH QUANTIFICATION IN THE CERVIX FOR PREDICTING OUTCOME OF LABOR INDUCTION. Ultrasound Med Biol 2020; 46:2207-2214. [PMID: 32565129 DOI: 10.1016/j.ultrasmedbio.2020.04.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 06/11/2023]
Abstract
This study aimed to explore the feasibility of transperineal virtual touch tissue quantification (VTQ) for predicting the outcome of labor induction. A total of 80 nulliparous pregnant women were included. Before labor induction, cervical length was measured by B-mode sonography, cervical stiffness was measured by VTQ, and Bishop score was assessed by vaginal examination. Subsequently, labor was induced using standard oxytocin infusion in all patients. Delivery within 24 hours after labor induction was classified as spontaneous delivery; otherwise, cesarean delivery was performed. Out of 80 participants, 48 (60%) delivered vaginally and 32 (40%) underwent cesarean delivery. The cervical length was significantly longer and the shear wave velocity (SWV) was greater in the cesarean delivery group than in the vaginal delivery group (p = 0.004 and p < 0.000, respectively). Logistic regression analysis indicated that only the mean SWV had independent predictive value for the outcome of labor induction (p = 0.011). The best diagnostic cut-off point of the mean SWV was 1.23 m/s, with a sensitivity of 93.8% and a specificity of 89.6%. Transperineal VTQ technique could predict the outcome of labor induction using oxytocin.
Collapse
Affiliation(s)
- Xiumei Li
- Department of Abdominal Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao 276003, Shandong, China
| | - Li Li
- Department of Ultrasound, Rizhao People's Hospital, Rizhao 276500, Shandong, China
| | - Yong Li
- Department of Gynecology, The Affiliated Hospital of Qingdao University, Qingdao 276003, Shandong, China
| | - Shibao Fang
- Department of Abdominal Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao 276003, Shandong, China
| | - Cheng Zhao
- Department of Abdominal Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao 276003, Shandong, China
| | - Yongchun Zhang
- Department of Radiation Oncology, The Affiliated Hospital of Qingdao University, Qingdao 276003, Shandong, China
| | - Zongli Yang
- Department of Abdominal Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao 276003, Shandong, China.
| |
Collapse
|
4
|
Gillor M, Levy R, Barak O, Ben Arie A, Vaisbuch E. Can assessing the angle of progression before labor onset assist to predict vaginal birth after cesarean?: A prospective cohort observational study. J Matern Fetal Neonatal Med 2020; 35:2046-2053. [PMID: 32519917 DOI: 10.1080/14767058.2020.1777269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: To assess whether pre-labor measurement of the angle of progression (AOP) can assist in predicting a successful vaginal birth after cesarean in women without a previous vaginal birth.Methods: A prospective observational cohort study performed in a single tertiary center including women at term with a single previous cesarean delivery (CD), without prior vaginal births, who desire a trial of labor. Transperineal ultrasound was used to measure the AOP before the onset of labor. The managing staff in the delivery suite was blinded to the ultrasound measurements. Clinical data and delivery outcome were retrieved from medical records. The study was approved by the institutional ethics committee (KMC 0117-10).Results: Of the 111 women included in the study, 67 (60.4%) had a successful vaginal birth after CD. Women were sonographically assessed at a median of 3 days [interquartile range (IQR) 1-3 days] prior to delivery. The median AOP was significantly narrower in women who eventually underwent a CD than in those who delivered vaginally (88°, IQR 78-96° vs. 99°, IQR 89-107°, respectively; p < .001). An AOP >98° (derived from a receiver operating characteristic curve) was associated with a successful vaginal birth after CD in 87.5% of women. Multivariable regression analysis demonstrated that each additional 1° in the AOP increases the chance for a successful vaginal birth after CD by 6%.Conclusions: Pre-labor AOP may be a useful sonographic tool for predicting vaginal birth after CD and can assist in consulting primiparous women with a prior CD opting for a trial of labor.
Collapse
Affiliation(s)
- Moshe Gillor
- Department of Obstetrics and Gynecology, Kaplan Medical Center, Hebrew University and Hadassah School of Medicine, Rehovot, Israel
| | - Roni Levy
- Department of Obstetrics and Gynecology, Kaplan Medical Center, Hebrew University and Hadassah School of Medicine, Rehovot, Israel
| | - Oren Barak
- Department of Obstetrics and Gynecology, Kaplan Medical Center, Hebrew University and Hadassah School of Medicine, Rehovot, Israel
| | - Alon Ben Arie
- Department of Obstetrics and Gynecology, Kaplan Medical Center, Hebrew University and Hadassah School of Medicine, Rehovot, Israel
| | - Edi Vaisbuch
- Department of Obstetrics and Gynecology, Kaplan Medical Center, Hebrew University and Hadassah School of Medicine, Rehovot, Israel
| |
Collapse
|
5
|
Songserm V, Komwilaisak R, Saksiriwuttho P, Kongwattanakul K. Transperineal versus transvaginal sonographic measurements of cervical length in pregnant women between 16 and 24 weeks of gestation. J Clin Ultrasound 2019; 47:389-393. [PMID: 31245845 DOI: 10.1002/jcu.22640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 06/20/2018] [Accepted: 08/24/2018] [Indexed: 06/09/2023]
Abstract
PURPOSE To investigate the correlation between cervical length measurements using transvaginal and transperineal approaches at 16-24 weeks of gestation. METHODS The prospective study recruited 110 singleton pregnant women. All the measurements were performed by one operator who was blinded to the results of both approaches. Cervical length was first measured by transvaginal sonography (TVUS) then transperineal sonography (TPUS). The transvaginal approach was used as the reference measurement. Patient preference regarding the sonographic approaches was evaluated using questionnaire. RESULTS Cervical length was successfully measured by TVUS in all cases. TPUS was successful in 108/110 participants. There was high correlation between the results of TVUS and TPUS (Pearson's correlation coefficient was .94; 95% CI .9 to .95. Lin's concordance correlation coefficient was .94; 95% CI .92-.96). The estimated difference in cervical length measured using TVUS and TPUS was .2 mm. The 95% tolerance interval for paired observation was -1.8 to 2.3 mm. The interobserver coefficient of TPUS measurement was .98 (95% CI .92-.99). TPUS was rated as resulting in mild or no discomfort and was preferred by most women. CONCLUSION TVUS and TPUS techniques showed high correlation in cervical length measurement with high interobserver reliability. More patients preferred TPUS. TPUS should be considered as an alternative method of cervical length measurement.
Collapse
Affiliation(s)
- Vilasinee Songserm
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Ratana Komwilaisak
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Piyamas Saksiriwuttho
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kiattisak Kongwattanakul
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| |
Collapse
|
6
|
Usman S, Barton H, Wilhelm-Benartzi C, Lees CC. Ultrasound is better tolerated than vaginal examination in and before labour. Aust N Z J Obstet Gynaecol 2019; 59:362-366. [PMID: 30024022 DOI: 10.1111/ajo.12864] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 06/19/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Intrapartum ultrasound has been proposed as a method of assessing labour progress but its acceptability has not been comprehensively assessed. AIMS We evaluated the acceptability of intrapartum ultrasound in women having vaginal examination (VE) and ultrasound (US) assessment (transabdominal (TA) and transperineal (TP)) prior to delivery, with and without regional analgesia (RA). MATERIALS AND METHODS Women at 24-42 weeks gestation were included in a prospective observational cohort study. The acceptability of digital VE and TP US were assessed pre- and post-examination using the modified validated Wijma Delivery Experience Questionnaire. Acceptability scores ranged 6-36 (6 being most and 36 being least positive) in six domains: positive-trust and relax, negative-harmful to baby, worrying, painful, intrusive. RESULTS Of 119 women recruited, 104 completed both pre- and post-assessment questionnaires. Eighty-nine per cent of women were nulliparous with median gestation 40 + 2 weeks (25-42+1 ). Thirty-two per cent had RA before assessment, 91% in total. The combined acceptability scores of both negative and positive experiences (6 = most acceptable, 36 = least acceptable) for VE and US pre-assessment were 15 and 7 respectively (P < 0.0001: Mann-Whitney U-test). VE was associated with less positive / more negative domain scoring post-assessment 12 and 6, respectively (P < 0.0001). Although RA made no difference to the perceived experience pre-VE (P = 0.9), post-VE, women with RAs considered VEs more acceptable than those without RA (P = 0.0022). CONCLUSION(S) This is the first study to comprehensively assess the acceptability of VE and intrapartum US. US assessment prior to delivery is more acceptable than VE. RA ameliorated the negative experience of the VE post-assessment.
Collapse
Affiliation(s)
- Sana Usman
- Department of Surgery and Cancer, Imperial College London, London, UK
- Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Helen Barton
- Department of Surgery and Cancer, Imperial College London, London, UK
- Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Charlotte Wilhelm-Benartzi
- Wales Cancer Trials Unit Centre for Trials Research, College of Biomedical & Life Sciences, Cardiff University, Cardiff, South Glamorgan, UK
| | - Christoph C Lees
- Department of Surgery and Cancer, Imperial College London, London, UK
- Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
| |
Collapse
|
7
|
Gillor M, Vaisbuch E, Zaks S, Barak O, Hagay Z, Levy R. Transperineal sonographic assessment of angle of progression as a predictor of successful vaginal delivery following induction of labor. Ultrasound Obstet Gynecol 2017; 49:240-245. [PMID: 27062415 DOI: 10.1002/uog.15931] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 03/23/2016] [Accepted: 03/29/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVES To assess whether measurement of the angle of progression (AOP) before induction of labor (IOL) can predict successful vaginal delivery in nulliparous women. METHODS This was a prospective, observational study of nulliparous women with a singleton term pregnancy and an indication for IOL. Transperineal sonography was used to measure the AOP before cervical ripening. Since all women enrolled had a low Bishop score, 98.6% of them were induced with either intracervical extra-amniotic balloon catheter or vaginal prostaglandin E-2. The staff in the labor ward were blinded to the AOP measurements. Clinical data were retrieved from computerized medical records. RESULTS Of the 150 women included in the final analysis, 40 (26.7%) delivered by Cesarean section. The median AOP was narrower in women who had a Cesarean delivery than in those who delivered vaginally (90° (interquartile range (IQR), 84-94.5°) vs 98° (IQR, 90.8-105°); P < 0.001). When including only women who underwent Cesarean delivery for non-progression of labor (n = 27) in the analysis, an AOP of > 92° (derived from a receiver-operating characteristics curve) was associated with a successful vaginal delivery in 94.8% of women. Multivariate stepwise logistic regression analysis including maternal age, body mass index, gestational age, estimated fetal weight, fetal head station, indication for IOL and AOP demonstrated that only AOP was independently associated with the prediction of a successful induction. CONCLUSION AOP may be a useful sonographic parameter for predicting successful vaginal delivery among nulliparous women at term undergoing IOL; an AOP wider than 92° is associated with a high rate of vaginal delivery. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
Collapse
Affiliation(s)
- M Gillor
- Department of Obstetrics and Gynecology, Kaplan Medical Center, Rehovot, Israel, affiliated to the Hebrew University and Hadassah School of Medicine, Jerusalem, Israel
| | - E Vaisbuch
- Department of Obstetrics and Gynecology, Kaplan Medical Center, Rehovot, Israel, affiliated to the Hebrew University and Hadassah School of Medicine, Jerusalem, Israel
| | - S Zaks
- Department of Obstetrics and Gynecology, Kaplan Medical Center, Rehovot, Israel, affiliated to the Hebrew University and Hadassah School of Medicine, Jerusalem, Israel
| | - O Barak
- Department of Obstetrics and Gynecology, Kaplan Medical Center, Rehovot, Israel, affiliated to the Hebrew University and Hadassah School of Medicine, Jerusalem, Israel
| | - Z Hagay
- Department of Obstetrics and Gynecology, Kaplan Medical Center, Rehovot, Israel, affiliated to the Hebrew University and Hadassah School of Medicine, Jerusalem, Israel
| | - R Levy
- Department of Obstetrics and Gynecology, Kaplan Medical Center, Rehovot, Israel, affiliated to the Hebrew University and Hadassah School of Medicine, Jerusalem, Israel
| |
Collapse
|
8
|
Wye D, Woo J, Mein B, Magotti R, Martin A, Benzie R. Transperineal use of a pocket-sized ultrasound machine vs conventional transvaginal ultrasound: a blinded comparison of cervical length in pregnancy. Ultrasound Obstet Gynecol 2016; 48:535-536. [PMID: 26776078 DOI: 10.1002/uog.15861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Revised: 01/07/2016] [Accepted: 01/08/2016] [Indexed: 06/05/2023]
Affiliation(s)
- D Wye
- Christopher Kohlenberg Department of Perinatal Ultrasound, Nepean Hospital, Penrith, NSW, Australia.
| | - J Woo
- Christopher Kohlenberg Department of Perinatal Ultrasound, Nepean Hospital, Penrith, NSW, Australia
| | - B Mein
- Christopher Kohlenberg Department of Perinatal Ultrasound, Nepean Hospital, Penrith, NSW, Australia
| | - R Magotti
- Christopher Kohlenberg Department of Perinatal Ultrasound, Nepean Hospital, Penrith, NSW, Australia
- University of Sydney, Nepean Hospital, Penrith, NSW, Australia
| | - A Martin
- University of Sydney, NHMRC Clinical Trials Centre, Sydney, NSW, Australia
| | - R Benzie
- Christopher Kohlenberg Department of Perinatal Ultrasound, Nepean Hospital, Penrith, NSW, Australia
- University of Sydney, Nepean Hospital, Penrith, NSW, Australia
| |
Collapse
|
9
|
Navarro-briceño Y, Reyna-villasmil E, Mejia-montilla J, Reyna-villasmil N, Torres-cepeda D, Santos-bolívar J, Fernández-ramírez A. Longitud cervical en el segundo trimestre por ecografía transperineal para la predicción de parto pretérmino. Perinatología y Reproducción Humana 2016; 30:63-8. [DOI: 10.1016/j.rprh.2016.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
10
|
Abstract
Introduction: The appropriate ultrasound technique to assess the maternal cervical length in women at low risk of preterm birth is yet to be established. This study aimed to determine the accuracy of different ultrasound approaches for measuring the maternal cervix in patients between 17 and 22 weeks gestation. Methods: The prospective study recruited 50 patients who were at a low risk of preterm birth. All measurements were acquired by one operator who was blind to the measurements being acquired in all approaches. The cervical length was registered using the transabdominal approach with a full and empty bladder, the transperineal approach and the transvaginal. The transvaginal approach was used as the reference measurement. Results: The transabdominal full bladder, post void, transperineal and transvaginal measurements were obtainable in 50, 49, 45 and 50 participants respectively. The transabdominal post void measurements showed a bias of -0.06 mm from perfect agreement with transvaginal. The transperineal measurements showed a bias of -0.16 mm. The transabdominal full bladder measurements were positively biased by 14.05 mm (p < 0.05). All transabdominal post void cervical lengths of 30 mm or greater registered a transvaginal cervical length greater than 25 mm in this study. Conclusion: The cervix should not be assessed in the transabdominal approach with a full maternal bladder due to overestimation of cervical length. Transvaginal cervical length can be reproduced accurately by post void transabdominal cervical length in most cases. Transperineal cervical length should be considered if transvaginal cervical length is contraindicated.
Collapse
Affiliation(s)
- Sandra O'Hara
- SKG Radiology West PerthPerthWestern AustraliaAustralia; Discipline of Medical Imaging, Department of Imaging and Applied PhysicsCurtin UniversityPerthWestern AustraliaAustralia
| | - Marilyn Zelesco
- Department of Medical Imaging Fiona Stanley Hospital Murdoch Western Australia Australia
| | - Zhonghua Sun
- Discipline of Medical Imaging, Department of Imaging and Applied Physics Curtin University Perth Western Australia Australia
| |
Collapse
|
11
|
O'Hara S, Zelesco M, Sun Z, Lee E. The maternal cervix: Why, when and how? Sonography 2015. [DOI: 10.1002/sono.12035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Sandra O'Hara
- SKG Radiology; Perth WA Australia
- Discipline of Medical Imaging, Department of Imaging and Applied Physics; Curtin University; Perth WA Australia
| | - Marilyn Zelesco
- Department of Medical Imaging; Fiona Stanley Hospital; Murdoch WA Australia
| | - Zhonghua Sun
- Discipline of Medical Imaging, Department of Imaging and Applied Physics; Curtin University; Perth WA Australia
| | - Emmeline Lee
- Western Ultrasound for Women; SJOG Wexford Medical Centre Australia
- Sir Charles Gairdner Hospital; Hospital Ave Nedlands WA Australia
| |
Collapse
|
12
|
Affiliation(s)
- Sana Usman
- Imperial CollegeInstitute of Reproductive Developmental BiologyHammersmith CampusW12 0DN; Queen Charlottes and Chelsea HospitalImperial College Healthcare NHS TrustDu Cane RoadLondonW12 0HS
| | - Christoph Lees
- Imperial CollegeInstitute of Reproductive Developmental BiologyHammersmith CampusW12 0DN; Queen Charlottes and Chelsea HospitalImperial College Healthcare NHS TrustDu Cane RoadLondonW12 0HS
| |
Collapse
|
13
|
Podrasky AE, Javitt MC, Glanc P, Dubinsky T, Harisinghani MG, Harris RD, Khati NJ, Mitchell DG, Pandharipande PV, Pannu HK, Shipp TD, Siegel CL, Simpson L, Wall DJ, Wong-You-Cheong JJ, Zelop CM. ACR appropriateness Criteria® second and third trimester bleeding. Ultrasound Q 2013; 29:293-301. [PMID: 24263752 DOI: 10.1097/RUQ.0000000000000044] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Vaginal bleeding occurring in the second or third trimesters of pregnancy can variably affect perinatal outcome, depending on whether it is minor (i.e. a single, mild episode) or major (heavy bleeding or multiple episodes.) Ultrasound is used to evaluate these patients. Sonographic findings may range from marginal subchorionic hematoma to placental abruption. Abnormal placentations such as placenta previa, placenta accreta and vasa previa require accurate diagnosis for clinical management. In cases of placenta accreta, magnetic resonance imaging is useful as an adjunct to ultrasound and is often appropriate for evaluation of the extent of placental invasiveness and potential involvement of adjacent structures. MRI is useful for preplanning for cases of complex delivery, which may necessitate a multi-disciplinary approach for optimal care.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every two years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
Collapse
|
14
|
Gauthier T, Marin B, Garuchet-bigot A, Kanoun D, Catalan C, Caly H, Eyraud J, Aubard Y. Transperineal versus transvaginal ultrasound cervical length measurement and preterm labor. Arch Gynecol Obstet 2014; 290:465-9. [DOI: 10.1007/s00404-014-3229-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Accepted: 03/24/2014] [Indexed: 10/25/2022]
|
15
|
Lehnert BE, Dighe MK. Second and third trimester bleeding. Ultrasound Q 2013; 29:303-5. [PMID: 24263753 DOI: 10.1097/ruq.0000000000000047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Bruce E Lehnert
- *Harborview Medical Center, University of Washington, and †Section Chief - Body Imaging, University of Washington Medical Center, Seattle, WA
| | | |
Collapse
|
16
|
Abstract
Introduction: Preterm birth is the leading cause of neonatal morbidity and mortality not attributable to congenital anomalies or aneuploidy. It has been shown that a shortened cervix is a powerful indicator of preterm births in women with singleton and twin gestations - the shorter the cervical length, the higher the risk of spontaneous preterm birth. Ultrasound measurements of the cervix are a more accurate way of determining cervical length (CL) than using a digital method. Background: There are three approaches that may be used to perform ultrasound measurements of the cervix; these are the transabdominal (TA), transperineal (TP) and the transvaginal (TV) approach. The TV approach is considered to be the gold standard. In women who are considered to be at a high risk of preterm birth it is now recommended that the cervix is measured at the mid-trimester ultrasound using the TV ultrasound approach. For women considered to be at a historical low risk the TV scan is not recommended, however it has been found that many women who deliver a preterm baby have no known risk factors. Conclusion: There is contradictory evidence in the literature with regard to the correlation between TA, TP and TV measurements. This article provides an overview of these three approaches with a focus on the clinical value for the assessment of the maternal cervix.
Collapse
Affiliation(s)
- Sandra O'Hara
- SKG Radiology West PerthPerthWestern AustraliaAustralia; Discipline of Medical ImagingDepartment of Imaging and Applied PhysicsCurtin UniversityPerthWestern AustraliaAustralia
| | | | - Zhonghua Sun
- Discipline of Medical Imaging Department of Imaging and Applied Physics Curtin University Perth Western Australia Australia
| |
Collapse
|
17
|
|