Transvaginal Ultrasound Measurement of the Uterocervical Angle for Prediction of Spontaneous Preterm Birth

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Kulwadee Kitipoonwongwanid
Adjima Soongsatitanon


Objective: To determine the predictive values for spontaneous preterm birth by using transvaginal ultrasonography of the uterocervical angle (UCA) in pregnant women with 16-24 weeks’ gestation

Material and Methods:  A prospective cohort study was conducted in singleton pregnant women with 16-24 weeks’ gestation. The UCA was performed at the time of cervical length screening. The data were recorded. Then the predictive values for spontaneous preterm birth were calculated.

Results: The data from 528 pregnant women was analyzed. Fifty-nine women developed spontaneous preterm birth and seven of these developed preterm birth at < 34 weeks. The UCA was significantly wider in preterm group when compare with controls (102.8 degrees vs 88.7 degrees, P<0.001). The sensitivity, specificity, positive predictive value and negative predictive values of the UCA more than 95 degrees for prediction of spontaneous preterm birth were 74.6%, 64.6%, 21.0% and 95.3% respectively. 

Conclusion: A wide uterocervical angle > 95 degrees detected during the second trimester was associated with an increased risk for spontaneous preterm birth < 37 weeks. This data showed that the uterocervical angle may be used as a screening tool for spontaneous preterm birth.


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