THE ROLE OF TRANSVAGINAL SONOGRAPHY IN PREDICTING RECURRENT PRETERM LABOR IN PATIENTS WITH INTACT MEMBRANES

Our purpose was to determine whether funnelling of the cervical intern al os, length of the endocervical canal, cervical index, funnel length and funnel width determined by transvaginal sonography are predictive of recurrent preterm labour. Of 112 women, 65 admitted to the hospita l for preterm labour with intact membranes had transvaginal sonographi c evaluation of the cervix before digital cervical examination and ins titution of tocolysis. The following measurements were obtained: (1) p resence of funnelling, (2) endocervical canal length, (3) cervical ind ex, (4) funnel length and (5) funnel width. Logistic regression analys is was performed to determine the variables that made a significant co ntribution to the prediction of recurrent preterm labour. A total of 6 5 eligible women completed the study. Recurrent preterm labour was sig nificantly associated with the presence of funnelling (85.2% vs. 23.3% ) and short endocervical canal length, large cervical index and long f unnel length as noted on transvaginal cervical sonography. The presenc e of funnelling, shorter endocervical canal length, larger cervical in dex and longer funnel length were suggestive of true preterm labour an d its recurrence. Transvaginal sonographic examination of the uterine cervix is a useful procedure to predict recurrent preterm labour with intact membranes. (C) 1997 Elsevier Science Ireland Ltd.