Accuracy of Transvaginal Ultrasound in Prediction of Latency Period in Women with Preterm Premature Rupture of Membranes

Abstract

Background: Preterm prelabor rupture of membranes (PPROM) is a major cause of Pretem Birth (PTB), Pretem Birth (PTB) is the most significant cause of perinatal morbidity and mortality worldwide. Cervical length (CL), posterior uterocervical angle (PUCA) and anterior uterocervical angle (AUCA) have been postulated in several studies to have an important role in prediction of PTB. Up to our knowledge, this is the first study that combines the three cervical parameters in prediction of latency period in women with PPROM. Aim of the Work: To assess the accuracy of cervical length, posterior uterocervical angle and anterior uterocervical angle in prediction of latency period in women with Preterm prelabor rupture of membranes. Subjects and Methods: A Prospective cohort study on 205 women with PPROM was held at Ain Shams University Maternity Hospital, a transvaginal ultrasound was performed to measure cervical length, posterior uterocervical angle, anterior uterocervical angle. Results: A total of 205 pregnant women with PPROM were included in this study, the latency grade was within 2 days in 57 (27.8%) of cases while was after 2 days in 148 (72.2%) of cases. As regards cervical length cutoff value 25.0 mm, sensitivity was 78.9%, specificity was 65.5%, posterior uterocervical angle cutoff value 108.0˚, sensitivity was 93.0%, specificity was 60.1%, and anterior uterocervical angle cutoff value 106.0˚, sensitivity was 93.0%, specificity was 71.6%. Conclusion: The combination of cervical length (CL), posterior uterocervical angle (PUCA) and anterior uterocervical angle (AUCA) measurements greatly predicts the latency period in women with PPROM, and Anterior uterocervical angle (AUCA) ≥ 106.0˚ had the highest diagnostic value in predicting latency period within two days.

Ultrasonographic evaluation of cervical length and amniotic fluid index as predictor of pregnancy outcome in cases of preterm premature rupture of membrane

“…1 Complications of preterm birth are the most common direct cause of death in children <5 years of age, accounting for 15% of all child deaths worldwide. [2][3][4] There are various risk factors that may contribute to preterm birth, preterm premature rupture of membrane (PPROM) is one of them. PPROM is defined as spontaneous rupture of the fetal membranes before 37 completed weeks and before labor onset.…”