Accuracy of the Anterior Uterocervical Angle in Predicting the Transvaginal Cerclage Failure to Prevent Spontaneous Preterm Birth Relative to the Cervical Length in Sonography

Background & Objective: Spontaneous preterm birth (SPB) occurs in about ۱۰ to ۱۲ percentage of pregnancies and causes many complications and mortality during pregnancy periods (۱). The aim of this study was to determine the evaluation of uterocervical angle compared to cervical length as a sonographic method in predicting preterm delivery for patients who were undergoing the transvaginal cerclage. Materials & Methods: The present study was performed on ۹۱ pregnant women who were candidates for cerclage in ۲۰۱۹-۲۰۲۰. In this study, about ۱۶.۴۸ percentage of births were preterm and ۲۷.۴۷ percentage were post-term. During the study, routine cervical evaluation was performed by post-cerclage ultrasound and transvaginal ultrasound was performed in all patients one week after cerclage. Additional evaluation with transvaginal ultrasound was performed at intervals determined by the treating physicians with final ultrasound evaluation of the cervix up to ۲۸ weeks of gestation. Finally, the obtained data were entered into SPSS ۲۲ and statistically analyzed using t-test, Chi-square and Fisherchr('۳۹')s exact test. Results: The results of the present study showed that considering the existing thresholds (۹۵ and ۱۰۵) for the anterior uterosacral angle and the threshold ۲۵ for the cervical length index, all these indices were included ۱۰۰% sensitive. Conclusion: This sensitivity in the case of UCA higher than ۹۵°C was about ۸۰%, but the disadvantage of these indicators was their low specificity, so that these indicators were different ranging from ۳۰% in the case of (UCA ۱۰۵) to ۷.۱۵% in the case of (UCA ۹۵).

کلیدواژه ها:

Anterior uterocervical angle ، Cerclage ، Cervical Length ، Spontaneous preterm birth