Transvaginal ultrasound cervical length for prediction of spontaneous labour at term: a systematic review and meta‐analysis

Abstract

Background The possibility to predict the delivery date is a question frequently raised by pregnant women. However, a clinician has currently little to predict when a woman at term will deliver.Objective To evaluate the predictive accuracy of transvaginal ultrasound (TVU) cervical length (CL) for spontaneous onset of labour in singleton gestation enrolled at term by a meta-analysis.Search strategy We performed a literature search in electronic databases. Selection criteriaWe included only studies assessing the accuracy of TVU CL in prediction of spontaneous onset of labour in singleton gestations with vertex presentation who were enrolled at term.Data collection and analysis The primary outcome was the accuracy of CL for prediction of spontaneous labour within 7 days. Pooled sensitivities and specificities were calculated.Main results Five studies including 735 singleton gestations were included. For the prediction of spontaneous labour within 7 days for CL <30 mm the pooled sensitivity was 64% and pooled specificity was 60%. The higher the CL, the better the sensitivity; the lower the CL, the better the specificity. A woman with a singleton gestation at term and a TVU CL of 30 mm has a <50% chance of delivering within 7 days, while one with a TVU CL of 10 mm has an over 85% chance of delivery within 7 days.Conclusions TVU CL at term has moderate value in predicting the onset of spontaneous labour. A woman with a TVU CL of 10 mm or less has a high chance of delivering within a week.Tweetable abstract Cervical length at term has moderate value in predicting the onset of spontaneous labour.

Diagnostic accuracy of intracranial translucency in detecting spina bifida: a systematic review and meta-analysis

“…7 The DOR is defined as the ratio of the odds of the test being positive if the subject has a disease, relative to the odds of the test being positive if the subject does not have the disease, that is, LR+/LRÀ. 8 Potential publication bias was formally assessed through Egger's regression asymmetry test. Following specific indications for meta-analyses of diagnostic accuracy, we correlated individual study sample sizes with both sensitivity and specificity as measures of test accuracy.…”

“…The DOR is defined as the ratio of the odds of the test being positive if the subject has a disease, relative to the odds of the test being positive if the subject does not have the disease, that is, LR+/LR− …”

Cerclage for sonographic short cervix in singleton gestations without prior spontaneous preterm birth: systematic review and meta‐analysis of randomized controlled trials using individual patient‐level data

“…Few prognostic tests are available to predict PTB. Short cervical length (CL) measured by transvaginal sonography (TVS) has been shown to be a good predictor of spontaneous PTB in both singleton and twin gestations.…”

Cervical Evaluation

“…24 On the other hand, another recent systematic review and meta-analysis reported a moderate benefit of transvaginal ultrasound cervical length at 37–41 weeks for predicting spontaneous labor: a woman with a CL 30mm has less than a 50%, while one with a cervical length <10mm has greater than an 85%, chance of delivering within 7 days. 21 However, the pooled sensitivity in this analysis for cervical length <30mm was only 64% and pooled specificity only 60%.…”

“…3 With respect to term spontaneous labor, a recent meta-analysis demonstrated that a woman with singleton gestation and transvaginal ultrasound cervical length of >30 mm has less than 50% chance of spontaneous labor within 7 days, while her chance is greater than 85% if her cervical length is 10 mm. 21 These are only a few of the hundreds of studies of transvaginal ultrasound cervical length for prediction of delivery timing. Fortunately, for measuring cervical length, contemporary practitioners have more than their fingers at their fingertips.…”