Ultrasound differentiation of the competent from the incompetent cervix: Prevention of preterm delivery

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Abstract

To evaluate the feasibility of the use of serial ultrasound measurements of cervical length, membrane protrusion, and dilatation to discriminate between the competent and the incompetent cervix, 107 at-risk patients and 30 control subjects were examined prospectively. Patients were divided into five groups based on treatment and method of diagnosis. Epidemiologic, ultrasound, and outcome data were analyzed. Means and standard deviations for ultrasound measurements were established. Highly significant differences between all prediagnostic and postdiagnostic-pretreatment measurements were found (p < 0.001). Highly significant differences were also found between all postdiagnostic-pretreatment and postdiagnostic-posttreatment measurements (p < 0.001). No significant differences between prediagnostic and postdiagnostic-posttreatment measurements were noted. The incidence of preterm delivery was significantly higher among untreated diagnosed patients (p < 0.01). By combined clinical and ultrasound criteria 51 patients (47.7%) were identified as not having cervical incompetency. Fifty-six patients (52.3%) were diagnosed.

References (6)

  • IA McDonald

    Cervical cerclage

    Clin Obstet Gynecol

    (1980)
  • L Cousins

    Cervical incompetence, 1980: a time for reappraisal

    Clin Obstet Gynecol

    (1980)
  • DA Sarti et al.

    Ultrasonic visualization of a dilated cervix during pregnancy

    Radiology

    (1979)
There are more references available in the full text version of this article.

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