Can transvaginal ultrasonographic evaluation of the endocervical glandular area predict preterm labor among patients who received tocolytic therapy for threatened labor: a cross-sectional study

Kahyaoğlu, Serkan; Kaymak, Oktay; Sağnıç, Saliha; Mollamahmutoğlu, Leyla; Danışman, Nuri

doi:10.3109/14767058.2013.766703

Cited by 9 publications

(7 citation statements)

References 22 publications

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“…Regarding the assessment of tissue elasticity, several strategies such as the cervical consistency index [59] and a cervical aspiration device [60] have also been evaluated. The absence of the cervical gland area has also been proposed as a predictor of preterm birth [61,62]. …”

Section: Resultsmentioning

confidence: 99%

Definition of Failed Induction of Labor and Its Predictive Factors: Two Unsolved Issues of an Everyday Clinical Situation

et al. 2015

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Objective: The objectives of this review were to identify the predictive factors of induction of labor (IOL) failure or success as well as to highlight the current heterogeneity regarding the definition and diagnosis of failed IOL. Materials and Methods: Only studies in which the main or secondary outcome was failed IOL, defined as not entering the active phase of labor after 24 h of prostaglandin administration ± 12 h of oxytocin infusion, were included in the review. The data collected were: study design, definition of failed IOL, induction method, IOL indications, failed IOL rate, cesarean section because of failed IOL and predictors of failed IOL. Results: The database search detected 507 publications. The main reason for exclusion was that the primary or secondary outcomes were not the predetermined definition of failed IOL (not achieving active phase of labor). Finally, 7 studies were eligible. The main predictive factors identified in the review were cervical status, evaluated by the Bishop score or cervical length. Discussion: Failed IOL should be defined as the inability to achieve the active phase of labor, considering that the definition of IOL is to enter the active phase of labor. A universal definition of failed IOL is an essential requisite to analyze and obtain solid results and conclusions on this issue. An important finding of this review is that only 7 of all the studies reviewed assessed achieving the active phase of labor as a primary or secondary IOL outcome. Another conclusion is that cervical status remains the most important predictor of IOL outcome, although the value of the parameters explored up to now is limited. To find or develop predictive tools to identify those women exposed to IOL who may not reach the active phase of labor is crucial to minimize the risks and costs associated with IOL failure while opening a great opportunity for investigation. Therefore, other predictive tools should be studied in order to improve IOL outcome in terms of health and economic burden.

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Section: Resultsmentioning

confidence: 99%

Definition of Failed Induction of Labor and Its Predictive Factors: Two Unsolved Issues of an Everyday Clinical Situation

et al. 2015

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“…The different incidence of absent CGA among these studies may be due to the difference in study design and choice of subjects. In 2013, 85 women with threatened PTL symptoms were examined by Kahyaoglu et al ( 10 ). They demonstrated the presence of echogenic (not echolucent) CGA on transvaginal ultrasonography is associated with PTL among patients with a short cervix that is in contrast to our results.…”

Section: Discussionmentioning

confidence: 99%

“…However, it disappears with advancing pregnancy or earlier in PTL ( 9 ). It seems that previous studies on the CGA are still not sufficient and further studies addressing this issue are needed ( 10 , 11 ).…”

Section: Introductionmentioning

confidence: 99%

Cervical gland area as an ultrasound marker for prediction of preterm delivery: A cohort study

Marsoosi

Pirjani

Jafarabadi

et al. 2017

IJRM

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Background:Preterm labor is a major cause of perinatal morbidity and mortality and it might be predicted by assessing the cervical change.Objective: To assess the association between absence of cervical gland area (CGA) and spontaneous preterm labor (SPTL).Materials and Methods: This prospective cohort study was performed on 200 singleton pregnant women with a history of SPTL, second-trimester abortion in the previous pregnancy or lower abdominal pain in current pregnancy. Each patient underwent one transvaginal ultrasound examination between 14-28 wk of gestation. Cervical length was measured and CGA was identified and their relationship with SPTL before 35 and 37 wk gestation was evaluated using STATA software version 10.Results:The mean of cervical length was 36.5 mm (SD=8.4), the shortest measurement was 9 mm, and the longest one was 61 mm. Short cervical length (≤18mm) was significantly associated with SPTL before 35 and 37 wk gestation.Cervical gland area (the hypoechogenic or echogenic area around the cervical canal) was present in 189 (94.5%) patients. Absent of CGA had a significant relationship with SPTL before 35 and 37 wk gestation (p=0.01 and p<0.001, respectively). Cervical length was shorter in women with absent CGA in comparison with subjects with present CGA: 37±10 mm in CGA present group and 23±9 mm in CGA absent group (p<0.001).Conclusion:Our study showed that cervical gland area might be an important predictor of SPTL which should be confirmed with further researches.

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“…2 Therefore, the absence of the CGA can be clinically useful as a sonographic marker for cervical maturation in normal pregnancy and the prediction of preterm delivery. [2][3][4][5][6][7][8] Previous studies have focused on the presence or absence of CGA during the progression of gestation. However, there are no studies concerning the quantitative evaluation of longitudinal changes in the CGA, such as the actual length of the sonographically described cervical gland.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the CGA disappears at the second trimester in cases of preterm delivery before 32 weeks of gestation 2 . Therefore, the absence of the CGA can be clinically useful as a sonographic marker for cervical maturation in normal pregnancy and the prediction of preterm delivery 2–8 . Previous studies have focused on the presence or absence of CGA during the progression of gestation.…”

Section: Introductionmentioning

confidence: 99%

Gestational age‐related changes in cervical gland length in normal singleton pregnancies from 17 to 36 weeks of gestation

Shimizu

Yoshizato

Kawakami

et al. 2023

J of Obstet and Gynaecol

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Aim To determine the gestational age‐related changes in cervical gland length in relation to cervical length (CL) in normal singleton pregnancies. Methods We studied 363 women with an uncomplicated singleton pregnancy (188 nulliparous and 175 multiparous women with one or more previous transvaginal deliveries). A total of 1138 cervical gland and CLs were measured longitudinally at 17–36 weeks of gestation using transvaginal ultrasonography along the curvature from the external os to the lower uterine segment and the internal end of the cervical gland area (CGA), respectively. Gestational age‐related changes in cervical gland and CLs and their relationships were analyzed using a linear mixed model. Results Cervical gland and CLs decreased in different ways with advancing gestation depending on parity, and their changes were related to each other. The CGAs in nulliparous women were longer than those in multiparous women at 17–25 weeks of gestation (p < 0.05), but with no differences thereafter. CLs in multiparous women were different from those in nulliparous women at 17–23 and 35–36 weeks (p < 0.05), but there were no differences at 24–34 weeks. The cervix did not shorten compared with the CGA throughout the observational periods in nulliparous and multiparous women. Conclusions Shortening of the cervix indicates changes to the lower uterine segment in normal pregnancies. The cervical gland region can be a useful marker representing the true cervix beyond 25 weeks of gestation, irrespective of parity.

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Can transvaginal ultrasonographic evaluation of the endocervical glandular area predict preterm labor among patients who received tocolytic therapy for threatened labor: a cross-sectional study

Abstract: The presence of CGA detected on transvaginal ultrasonography especially when combined with the evaluation of CL during the management of patients with threatened labor can be a reassuring sign for actual probability of PTD.

Cited by 9 publications

References 22 publications

Definition of Failed Induction of Labor and Its Predictive Factors: Two Unsolved Issues of an Everyday Clinical Situation

Definition of Failed Induction of Labor and Its Predictive Factors: Two Unsolved Issues of an Everyday Clinical Situation

Cervical gland area as an ultrasound marker for prediction of preterm delivery: A cohort study

Gestational age‐related changes in cervical gland length in normal singleton pregnancies from 17 to 36 weeks of gestation

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