Distribution of uterocervical angles in the second trimester of pregnant women at low risk for preterm delivery

Sawaddisan, Rapphon; Kor-anantakul, Ounjai; Pruksanusak, Ninlapa; Geater, Alan

doi:10.1080/01443615.2020.1718622

Cited by 8 publications

(4 citation statements)

References 22 publications

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“…Similarly, the study of Llobet et al [ 27 ] with 275 singleton pregnant women showed that the mean UCA values increased from the first to the second trimester with statistical significance (84.2° versus 94.5°, p = 0.019). Sawaddisan et al [ 28 ] (Thailand, 2020) studied 372 singleton pregnant women at GAs from 16 + 0 to 23 + 6 weeks and showed that UCA values changed according to GA, but this change was not statistically significant (increase of 0.3° per week, p = 0.757).…”

Section: Discussionmentioning

confidence: 99%

Distribution of uterocervical angles of pregnant women at 16+ 0 to 23+ 6 weeks gestation with low risk for preterm birth: first vietnamese cohort of women with singleton pregnancies

Nguyen¹,

Vu²,

Nguyen³

2023

BMC Pregnancy Childbirth

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Background Cervical length (CL) measured by ultrasound in the second trimester is a predictor of spontaneous preterm birth (sPTB). The uterocervical angle (UCA) has recently been suggested as a predictor to identify women at risk of sPTB. The aim of this study was to investigate the UCAs’ distribution in singleton pregnant women at 16+ 0 − 23+ 6 weeks of gestation with low risk for sPTB. Methods This was a prospective cohort study of 1,051 pregnant women with singleton pregnancies at low risk for preterm delivery. Pregnant women with a viable singleton fetus at 16+ 0 − 23+ 6 weeks of gestation were enrolled in the study conducted at the Haiphong Hospital of Obstetrics and Gynecology, Vietnam, from 09/2019 to 09/2020. CL and the UCA were assessed using transvaginal ultrasonography (TVS) by a single sonographer. Subjects were followed-up until the end of pregnancy, and maternal and neonatal outcomes were recorded. The UCAs’ range and their relationship with gestational age were evaluated using regression analysis. P < 0.05 was considered statistically significant. Results The normal range of the UCA (5th − 95th percentiles) was 46.47° (95% CI, 40.27°-51.81°) to 127.06° (95% CI, 123.02° − 130.71°). The UCAs in the preterm birth (< 37 weeks) and full-term groups were 117.86° ± 20.25° and 83.80° ± 24.18°, respectively (p < 0.001). Linear regression analysis showed a significant change in the UCA range from 16+ 0 to 23+ 6 weeks of gestation (2.51 degrees per week, p < 0.001). The linear function yielded the highest correlation coefficient in the variation rule of the UCA values (r = 0.22). A total of 42/63 (66.7%) patients with preterm birth < 37 weeks had a UCA above the 75th percentile. The majority of women with preterm birth had a UCA ≥ 95° compared with those with full-term delivery (88.9% vs. 31.3%, p < 0.001). Conclusions The results of this study present background information about the normal range of UCA values in singleton pregnant women at 16+ 0 to 23+ 6 weeks at low risk for sPTB in this Vietnamese cohort. In this study population at low risk for sPTB, pregnant women with a UCA value ≥ 95o were also considered at risk for preterm birth.

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Section: Discussionmentioning

confidence: 99%

Distribution of uterocervical angles of pregnant women at 16+ 0 to 23+ 6 weeks gestation with low risk for preterm birth: first vietnamese cohort of women with singleton pregnancies

Nguyen¹,

Vu²,

Nguyen³

2023

BMC Pregnancy Childbirth

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“…ImageJ software was used by an attending ultrasound physician with more than 5 years of work experience to measure the UCA on the previously stored cervical image again, and repeated 3 times to obtain the average value. The angle between the lower segment of the uterus and the internal and external os of the cervix was considered the UCA ( Sawaddisan et al, 2020 ) ( Figure 2 ).…”

Section: Methodsmentioning

confidence: 99%

Changes of uterocervical angle and cervical length in early and mid-pregnancy and their value in predicting spontaneous preterm birth

Zhang,

Li,

Tian

et al. 2024

Front. Physiol.

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Objective: To explore the feasibility of transvaginal ultrasound measurement of uterocervical angle (UCA) and cervical length (CL) in early and mid-pregnancy and evaluate their combined prediction of spontaneous preterm birth (sPTB) in singleton pregnancies.Patients and Methods: This retrospective study comprised 274 pregnant women who underwent transvaginal ultrasound measurement of CL in mid-pregnancy (15–23+6 weeks); in 75 among them, CL also had been measured in early-pregnancy (<14 weeks). These 274 pregnant women were further divided into a preterm group (n = 149, <37 weeks gestation) and a control group (n = 125, >37 weeks gestation) according to delivery before or after 37 weeks, respectively. In the preterm group, 35 patients delivered before 34 weeks and the remaining 114 delivered between 34 and 37 weeks.Results: The optimal threshold of CL to predict preterm birth risk in women with <37 weeks gestation was 3.38 cm, and the optimal threshold of the UCA to predict preterm birth risk in the same group of women was 96°. The optimal threshold of CL to predict preterm birth risk in women with <34 weeks gestation was 2.54 cm, while that of the UCA in the same group of patients was 106°. The area under the curve for predicting preterm birth by combining the UCA and CL measurements was greater than that by using the UCA or CL alone (p < 0.01). The sensitivity and specificity for predicting preterm birth at <34 weeks gestation was 71.7% and 86.4%, respectively; and the sensitivity and specificity for predicting preterm birth at <37 weeks gestation was 87.6% and 80.6%, respectively. The difference between the two groups in CL and UCA were not significant in early pregnancy (p > 0.01), but only in mid-pregnancy (p < 0.01). There was a negative correlation between UCA and gestational week at delivery (r = −0.361, p < 0.001) and a positive correlation between CL and gestational week at delivery (r = 0.346, p < 0.001) in mid-pregnancy. The proportion of deliveries at <34 weeks was highest when the UCA was >105°, and the proportion of deliveries between 35 and 37 weeks was highest when the UCA was between 95° and 105°. The proportion of deliveries at <34 weeks was highest when the CL was <2.5 cm.Conclusion: The combination of UCA and CL has a better ability to predict preterm birth than either measurement alone. A more obtuse UCA or a shorter CL is associated with an earlier spontaneous preterm birth. The UCA increases from early to mid-pregnancy, while the CL decreases from early to mid-pregnancy.

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“…One article was excluded because it specifically included pregnant women diagnosed with idiopathic polyhydramnios [23]. Of the eight articles remaining for a more thorough evaluation, one was excluded from the quantitative meta-analysis, as it hadan uninterpretable or incomplete data set [24], andanother one because it presented the data as median, not mean values [25]. Thus, six articles remained to be included in the meta-analysis [7,[26][27][28][29][30].…”

Section: Literature Search and Study Characteristicsmentioning

confidence: 99%

“…In all thestudies included, birth weeks were correlated with the UCA measurement performed at different time intervals at the beginning of the second trimester. Only Sawaddisan et al [24] evaluated the UCA prediction success according to the weeks in which UCA measurement was performed. In this study, while comparing UCA values with term and spontaneous preterm deliveries, the patients were divided into two groups: gestational age 16 0/7 -24 0/7 weeks (n = 356) and gestational age above 19.5 weeks (n = 141).…”

Section: Qualitative Analysismentioning

confidence: 99%

Investigating the predictive role of uterocervical angle in predicting preterm labor in singleton pregnancies: a meta-analysis

Yenigul,

Dincgez,

Uzunoglu

et al. 2023

Ginekol Pol

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Objectives: In this meta-analysis, we aimedto demonstrate the relationship between uterocervical angle and preterm labor in singleton pregnancies more clearly and reliablywith this meta-analysis. Material and metods:In this study, we use keywords such as "uterocervical angle, " "cervical angle, " "angle, " "cervix, " "cervical, " "preterm, " and "preterm labour. " We searched various databases, including PubMed, MEDLINE, ClinicalKey, Scopus, ScienceDirect, Web of Science, and Google Scholar. The search encompassed the period from January 1, 2010, to December 27, 2020. As a result of the literature review, a total of 585 articles were identified. After the screening and selection process, six studies met the inclusion criteria and were included in the analysis. These six studies were deemed relevant and provided valuable information on the research topic.Results: When the Egger test (p = 0.020) and Begg test (p = 0.188) were performed, no significant publication bias was found in the studies examined. These statistical tests assess publication bias, and the resulting p-values indicate a low probability of bias in the included studies. Cochran's Q test revealed the presence of heterogeneity among the included studies. Heterogeneity indicates variability in the results beyond what would be expected by chance alone. This finding suggests that the studies may differ in methodologies, populations, or other factors, which could impact the overall results and require further investigation. There was a significant difference between the patient and control groups (p < 0.001). This result provides strong evidence to support the importance of the difference between the two groups compared. Conclusions:Based on the findings of this study, a wider uterocervical angle appeared to be significantly associated with an increased risk of preterm delivery in overall effect. It concluded that a wide uterocervical angle may be a potential risk factor for preterm delivery. Moreover, the study revealed a significant association between wider uterocervical angles and an elevated risk of preterm labour in singleton pregnancies. In this study, the definition of preterm birth accepts as birth before 37 weeks of gestation. These results highlight the potential significance of evaluating the uterocervical angle as a meaningful predictor for identifying the propensity of preterm labour in singleton pregnancies.

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Distribution of uterocervical angles in the second trimester of pregnant women at low risk for preterm delivery

Cited by 8 publications

References 22 publications

Distribution of uterocervical angles of pregnant women at 16+ 0 to 23+ 6 weeks gestation with low risk for preterm birth: first vietnamese cohort of women with singleton pregnancies

Distribution of uterocervical angles of pregnant women at 16+ 0 to 23+ 6 weeks gestation with low risk for preterm birth: first vietnamese cohort of women with singleton pregnancies

Changes of uterocervical angle and cervical length in early and mid-pregnancy and their value in predicting spontaneous preterm birth

Investigating the predictive role of uterocervical angle in predicting preterm labor in singleton pregnancies: a meta-analysis

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