ACR Appropriateness Criteria® Assessment of Gravid Cervix

Gyn, Expert Panel on; Imaging, OB; Oliver, Edward R.; Maturen, Katherine E.; Feldstein, Vickie A.; Pōder, Liina; Shipp, Thomas; Simpson, Lynn L.; Strachowski, Loretta M; Sussman, Betsy L; Weber, Therese M.; Winter, Tom; Glanc, Phyllis

doi:10.1016/j.jacr.2020.01.032

Cited by 4 publications

(4 citation statements)

References 52 publications

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“…We reviewed relevant recommendations related to the 12 clinical/diagnostic scenarios previously published by radiology and specialty societies, including: the Canadian Association of Radiologists, 9 the American College of Obstetricians and Gynecologists, 10,11 the American College of Radiology, 12 -28 the American Society of Clinical Oncology, 29 the European Society of Urogenital Radiology Scrotal and Penile Imaging Working Group, 30,31 the European Society of Urogenital Radiology, 32 the French College of Gynecologists and Obstetricians, 33 the International Society of Ultrasound in Obstetrics and Gynecology, 34 the International guideline on polycystic ovarian syndrome, 35 -38 the National Institute for Health and Care Excellence, 39 -47 the Society for Maternal-Fetal Medicine, 48 the Society of Abdominal Radiology, 49 the Society of Obstetricians and Gynaecologists of Canada, 50 -57 the Royal College of Obstetricians and Gynaecologists, 58 -60 and the 2017 Royal College of Radiologists. 61…”

Section: Resultsmentioning

confidence: 99%

Canadian Association of Radiologists Obstetrics and Gynecology Diagnostic Imaging Referral Guideline

Hamel,

Amir,

Avard

et al. 2023

Can Assoc Radiol J

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The Canadian Association of Radiologists (CAR) Obstetrics and Gynecology Expert Panel consists of radiologists specializing in obstetrics and gynecology, obstetrics and gynecology physicians, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 12 clinical/diagnostic scenarios, a systematic rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of these clinical/diagnostic scenarios. Recommendations from 46 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) for guidelines framework were used to develop 68 recommendation statements across the 12 scenarios related to the evaluation of obstetrics and gynecology clinical and diagnostic scenarios. This guideline presents the methods of development and the imaging recommendations for a variety of obstetrical and gynecological conditions including pregnancy assessment, recurrent first trimester pregnancy loss, post-partum indications, disorders of menstruation, localization of intra-uterine contraceptive device, infertility assessment, assessment of adnexal mass, pelvic pain of presumed gynecological origin, and pelvic floor evaluation.

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Section: Resultsmentioning

confidence: 99%

Canadian Association of Radiologists Obstetrics and Gynecology Diagnostic Imaging Referral Guideline

Hamel,

Amir,

Avard

et al. 2023

Can Assoc Radiol J

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“…Recommendations were developed for three patient groups, each at different risk for sPTB, and adapted from 19 existing CPGs rated as having the best underlying evidence [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] (Figures 3B-C in Supplementary file 2). Adaptation was necessary as none of these existing 'best evidence' CPGs directly addressed the clinical questions determined by the GDG as relevant to sonographers.…”

Section: Development Of Recommendationsmentioning

confidence: 99%

“…A 'how to guidance' section was developed using information from existing CPGs [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] and the clinical experience and knowledge of GDG members to provide practical tips for acquiring and interpreting TVS, TAS and TPS images. Most resource CPGs had low levels of supporting evidence.…”

Section: Development Of Other Information In the Cpgmentioning

confidence: 99%

“…Evidence-based clinical practice guidelines (CPGs) are useful in providing guidance when local protocols are not available. 2 To date evidence-based CPGs have focussed on the clinical management of patients, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] rather than answering questions relevant to the clinical practice of sonographers. The aim of this article is to introduce a new CPG that fills this gap by providing guidance for Australian and New Zealand sonographers on when and how to sonographically assess the gravid cervix.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound assessment of the gravid cervix to assess for risk of spontaneous preterm birth: Introducing an evidence‐based clinical guideline for sonographers

Thoirs,

O'Hara,

Quinton

et al. 2024

Sonography

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This article introduces a new evidence‐based clinical practice guideline (CPG) for sonographers; Ultrasound assessment of the gravid cervix to assess for risk of spontaneous preterm birth (sPTB). The purpose of this new CPG is to provide evidence‐based guidance for sonographers in Australia and New Zealand when making decisions on how and when they should sonographically assess the cervix in the gravid patient. Clinical questions relevant to the sonographic assessment of the gravid cervix were developed to inform the CPG. The primary sources to answer the clinical questions were relevant, existing CPGs. Recommendations in these existing CPGs were appraised for the level of evidence on which they were based and adapted for use in the new CPG. New recommendations were adapted from 19 existing CPGs rated as being based on best evidence and were applicable to three specific patient groups, each at different risk for sPTB. ‘How to Guidance’, statements about safety, acceptability, feasibility of ultrasound techniques, sonographer training and supplementary material were also developed using information from existing CPGs, relevant literature and the clinical experience of clinical guideline group members. The CPG recommendations, ‘how to guides’ and areas of future research are presented in this article. The full guideline and its supplementary materials are available at https://www.sonographers.org/resources-tools/clinical-guidance.

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Routine transabdominal cervical length screening in mid‐pregnancy for the prevention of preterm birth: Is it good enough to use as a screening test?

Pedretti,

Dickinson,

Doherty

et al. 2024

Aust NZ J Obst Gynaeco

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BackgroundPreterm birth (PTB) is a major pregnancy complication. There is evidence that a short cervical length in mid‐pregnancy may predict women at increased risk of PTB.AimsTo evaluate the utility of population‐based, transabdominal cervical length (TACL) measurement screening in mid‐pregnancy for PTB prediction in women.Materials and MethodsA transabdominal approach was initially performed, with a transvaginal (TVCL) approach offered when the TACL was <35 mm, could not be accurately measured, or the pregnancy had risk factors for PTB. TACL was compared to the directly related TVCL, when both were performed at the same assessment. Women with risk factors of PTB were included when they had both TACL and TVCL measurements performed at the same visit.ResultsData were provided for 9355 singleton pregnancies from 13 participating imaging centres. A transabdominal approach was used in 9006 (96.3%), including 682 (7.3%) TVCL combined with TACL. There were 349 (3.7%) women who had TVCL only. The median TACL was longer (40 mm) than the TVCL (38 mm). In 682 paired TACL and TVCL measurements, TACL <35 mm correctly identified 96.2% of pregnancies with TVCL <25 mm, compared with 65.4% of cases when using a TACL <30 mm. A TVCL <25 mm occurred in 59 (0.6%) women. A TACL <35 mm was associated with birth <37 weeks of gestation in 12.1% of women and birth <32 weeks of gestation in 3.9%.ConclusionsUniversal TACL is a feasible option for population screening of cervical length in a low‐risk population, progressing to TVCL if the TACL is <35 mm or the cervix cannot be transabdominally accurately measured.

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ACR Appropriateness Criteria® Assessment of Gravid Cervix

Cited by 4 publications

References 52 publications

Canadian Association of Radiologists Obstetrics and Gynecology Diagnostic Imaging Referral Guideline

Canadian Association of Radiologists Obstetrics and Gynecology Diagnostic Imaging Referral Guideline

Ultrasound assessment of the gravid cervix to assess for risk of spontaneous preterm birth: Introducing an evidence‐based clinical guideline for sonographers

Routine transabdominal cervical length screening in mid‐pregnancy for the prevention of preterm birth: Is it good enough to use as a screening test?

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