Evaluation of Uterocervical Angle and Cervical Length as Predictors of Spontaneous Preterm Birth

Pramod Kumar Singh; Resham Srivastava; Ishan Kumar; Sangeeta Rai; Saurabh Pandey; Ram C Shukla; Ashish Verma

doi:10.1055/s-0041-1741411

Evaluation of Uterocervical Angle and Cervical Length as Predictors of Spontaneous Preterm Birth

Indian J Radiol Imaging. 2022 Feb 28;32(1):10-15. doi: 10.1055/s-0041-1741411. eCollection 2022 Mar.

Authors

Pramod Kumar Singh¹, Resham Srivastava¹, Ishan Kumar¹, Sangeeta Rai², Saurabh Pandey¹, Ram C Shukla¹, Ashish Verma¹

Affiliations

¹ Department of Radiodiagnosis and Imaging, IMS, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
² Department of Obstetrics and Gynaecology, IMS, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

Abstract

Aim The aim of this article was to evaluate uterocervical angle (UCA) and cervical length (CL) measured at 16 to 24 weeks of gestation using transvaginal sonography (TVS) as predictors of spontaneous preterm birth. Methods In this prospective study, TVS was performed in 159 primigravidas with a singleton, uncomplicated pregnancy at 16 to 24 weeks of gestation to measure the anterior UCA and CL. All the cases were followed until labor to document gestational age at delivery. Results The risk of spontaneous preterm birth was higher in women with obtuse UCA (>95 degrees) with sensitivity of 86.7%, specificity of 93.0%, positive predictive value of 83.0%, negative predictive value of 94.6%, and p -value of <0.001. The difference between the means was statistically significant ( p -value < 0.001). UCAs ≥105degrees and 95 to 105 degrees were found to be significantly associated with spontaneous preterm births at <34 weeks and 34 to 37 weeks, respectively. CL <2.5 cm was found to predict spontaneous preterm births at <37 weeks with sensitivity of 31.1%, specificity of 95.6%, and p -value of <0.001. UCA was found to be a better predictor of spontaneous preterm birth with a higher coefficient of variation (56.4%) when compared with CL (16.9%). Conclusions UCA proved to be a novel ultrasound parameter that can serve as a better predictor of spontaneous preterm births in comparison to CL. A strong correlation exists between obtuse UCA and a risk of spontaneous preterm birth.

Keywords: cervical length; spontaneous preterm birth; transvaginal sonography; uterocervical angle.

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