Aim Does measurement of cervical length with transvaginal USS reduce intervention in a high risk group?
Material and methods A retrospective case note review of women at high risk of preterm delivery was undertaken from April 2006 to September 2009. A total of 64 women were identified. Cervical surveillance with transvaginal ultrasound was offered between 16 and 27 weeks. Women were referred to the service with previous history of extremely premature birth (<30 weeks), unexplained mid trimester loss, cone biopsy or congenital uterine anomaly. The number of scans was tailored to the patient's needs with a mean of 3.We also looked at the mode of delivery and survival to discharge of the babies.
Results 49 /64 (76.5%) women were managed conservatively with ultrasound. Out of these three women delivered under 36 weeks and two went on to have a late spontaneous abortion.
Ultrasound indicated cervical suture was inserted in15/64 (23%) patient. There were five preterm deliveries with three being extremely preterm. One baby died in the neonatal period. Overall there were 59 live births, all survived to discharge.
45/64 (70%) women delivered vaginally and 17/64 required a caesarean section (26.5%)
Conclusion We conclude that cervical length measurement by transvaginal ultrasound is an objective, reproducible and non-invasive tool highly acceptable to pregnant patients. This offers reassurance to a vast majority of patients at high risk of preterm along with reducing intervention in this subgroup.
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