Vaginal ultrasound as an adjunct to cervical digital examination in women at risk of early delivery

Aim:To study the utility of transvaginal ultrasound (TVU) in women at high risk of preterm delivery. Methods: Women who were scheduled for frequent di gital examinations of the cervix from 16 to 26 weeks of gestation had TVU d eterminations of cervical length before their clinical examinations, Clinic ians were blinded to the TVU results. Therefore, clinical decision-making w as independent of the unreported TVU data, The plan was to relate the ultra sound characterization of the cervix to the study's primary endpoint, the n eed for hospitalization prior to 26 weeks of gestation for: preterm prematu re rupture of membranes, preterm labor, cerclage placement, or delivery. Re sults: Seventeen subjects completed the study. All 3 who met the primary en dpoint had ultrasound cervical lengths <20 mm on earlier prenatal visits, w hen digital examinations of the cervix did not detect problems, A 4th woman had ultrasound lengths <20 mm (she delivered at 27(6)/(7) weeks). Conclusi on: TVU determination of cervical length provides an earlier warning of cer vical shortening than does digital examination. Copyright (C) 2001 S. Karge r AG, Basel.