DIAGNOSTIC ACCURACY OF TRANSABDOMINAL SONOGRAPHY IN DIAGNOSING SHORT CERVICAL LENGTH KEEPING TRANSVAGINAL SONOGRAPHY AS THE GOLD STANDARD

Authors

  • Sadia Mehmood Department of Radiology, DHQ Hospital, Narowal, Pakistan
  • Rimsha khan Fauji Foundation Hospital, Rawalpindi, Pakistan
  • Sarah Anwar Fauji Foundation Hospital, Rawalpindi, Pakistan
  • Sammia Yousaf Department of Radiology, DHQ Hospital, Narowal, Pakistan
  • Muntiha Ibtihaj Fauji Foundation Hospital, Rawalpindi, Pakistan
  • Alveena Waheed Islamabad Diagnostic Centre, Lahore, Pakistan

DOI:

https://doi.org/10.69656/pjp.v20i3.1651

Keywords:

diagnostic accuracy, short cervical length, transabdominal sonography, transvaginal sonography

Abstract

Background: Transvaginal ultrasound is a gold standard technique for diagnosing short cervix. This study aimed to determine the diagnostic accuracy of transabdominal sonography (TAS) in diagnosing short cervical length in 20–28 week pregnant women keeping transvaginal ultrasound as the gold standard. Methods: It was a cross-sectional study, conducted in the Department of Radiology, DHQ Hospital, Narowal from 1st July 2023 to 1st March 2024. A total of 321, 20–28 week pregnant women were included. Cervical length was measured initially by transabdominal ultrasound followed by transvaginal ultrasound. Results: Of the total 321 patients, 264 were true negative, 28 were false negative, 14 were false positive and 15 were true positive. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of TAS in assessing accurate cervical length are 34.8%, 94.8%, 51.7%, 90.4%, and 86.9% respectively. In all cases with transabdominal cervical length >35 mm, the NPV of transabdominal ultrasound reached 100%. Conclusion: TAS exhibits limited accuracy in correctly identifying short cervical length in women who indeed have a short cervical length. However, it demonstrates a strong ability to exclude short cervical length in women with a normal cervical length. Cervical length measured via transabdominal ultrasound can be reliably reported as safe if it exceeds 35 mm. For measurements below it, further evaluation with transvaginal ultrasound is recommended.

Pak J Physiol 2024;20(3):49–52,  DOI: https://doi.org/10.69656/pjp.v20i3.1651

Downloads

Download data is not yet available.

References

Ohuma EO, Moller AB, Bradley E, Chakwera S, Hussain-Alkhateeb L, Lewin A, et al. National, regional, and global estimates of preterm birth in 2020, with trends from 2010: a systematic analysis. Lancet 2023;402(10409):1261–71.

Perin J, Mulick A, Yeung D, Villavicencio F, Lopez G, Strong KL, et al. Global, regional, and national causes of under-5 mortality in 2000–19: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet Child Adolesc Health 2022;6(2):106–15.

Pervaiz S, Naeem MA, Ali A, John A, Batool N. Frequency of uterine anomalies associated with persistent miscarriages in pregnancy on ultrasound: Uterine anomalies associated with persistent miscarriages. Pak J Health Sci 2022;3(1):55–8.

Thain S, Yeo GSH, Kwek K, Chern B, Tan KH. Spontaneous preterm birth and cervical length in a pregnant Asian population. PloS One 2020;15(4):e0230125.

Enakpene CA, DiGiovanni L, Jones TN, Marshalla M, Mastrogiannis D, Della Torre M. Cervical cerclage for singleton pregnant patients on vaginal progesterone with progressive cervical shortening. Am J Obstet Gynecol 2018;219(4):397.e1–397.e10.

Souka AP, Papastefanou I, Pilalis A, Kassanos D, Papadopoulos G. Implementation of universal screening for preterm delivery by mid?trimester cervical?length measurement. Ultrasound Obstet Gynecol 2019;53(3):396–401.

Navathe R, Saccone G, Villani M, Knapp J, Cruz Y, Boelig R, et al. Decrease in the incidence of threatened preterm labor after implementation of transvaginal ultrasound cervical length universal screening. J Matern Fetal Neonatal Med 2019 3;32(11):1853–8.

Pedretti MK, Newnham JP, Dohery DA, Dickinson JE. EP19.21: Transabdominal cervical length screening in mid?pregnancy for preterm birth prevention: the impact of image quality on cervical length measurement. Ultrasound Obstet Gynecol 2023;62:226.

Peterson JA, Smolar I, Stoffels G, Bianco A. Intra?sonographer correlation between transabdominal and transvaginal cervical length measurements and associated patient demographics. J Ultrasound Med 2023;42(11):2583–8.

Usman A, Shafique M, Jalil J, Amin U, Zafar SI, Qamar K. Comparison of diagnostic accuracy of transperineal sonography with the transvaginal ultrasonography in determining accurate cervical length. Pak Armed Forces Med J 2019;69(1):136–41.

Ooi R, Ooi S, Wilson D, Griffiths A. Reaudit of transvaginal ultrasound practice in a general gynecology clinic. J Clin Ultrasound 2020;48(6):312–4.

Tsakiridis I, Mamopoulos A, Athanasiadis A, Dagklis T. Comparison of transabdominal and transvaginal ultrasonography for the assessment of cervical length in the third trimester of pregnancy. Taiwan J Obstet Gynecol 2019;58(6):784–7.

Ginsberg Y, Zipori Y, Khatib N, Schwake D, Goldstein I, Shrim A, et al. It is about time. The advantage of transabdominal cervical length screening. J Matern Fetal Neonatal Med 2022;35(24):4797–802.

Fitzpatrick A, DiGiacinto D. Comparison of transabdominal and transvaginal sonograms in evaluation of cervical length during pregnancy. J Diagn Med Sonogr 2021;37(5):466–71.

Guerby P, Beaudoin A, Marcoux G, Girard M, Pasquier JC, Bujold E. Ultrasonographic transabdominal measurement of uterine cervical length for the prediction of a midtrimester short cervix. Am J Perinatol 2021;38(12):1303–7.

Downloads

Published

30-09-2024

How to Cite

1.
Mehmood S, khan R, Anwar S, Yousaf S, Ibtihaj M, Waheed A. DIAGNOSTIC ACCURACY OF TRANSABDOMINAL SONOGRAPHY IN DIAGNOSING SHORT CERVICAL LENGTH KEEPING TRANSVAGINAL SONOGRAPHY AS THE GOLD STANDARD. Pak J Phsyiol [Internet]. 2024 Sep. 30 [cited 2024 Nov. 21];20(3):49-52. Available from: https://pjp.pps.org.pk/index.php/PJP/article/view/1651