Ultrasound cervical length for the prediction of preterm labor
Institute for Clinical Systems Improvement
Record ID 32003000571
English
Authors' objectives:
This review aims to assess the available evidence on the effectiveness of ultrasound cervical length for the prediction of preterm labor.
Authors' recommendations:
With regard to the use of ultrasound cervical length for the prediction of preterm labor, the ICSI Technology Assessment Committee finds:
Cervical length is a biological continuum.
Ultrasound measurement of cervical length is not recommended as a screening test for preterm labor in the general obstetric population.
Ultrasound is a safe procedure. The risks and limitations of the test are related to the false negative rate and the false positive rate.
Many studies have shown an inverse relationship between cervical length and the risk of preterm delivery.
The clinical benefit of cervical length measurements may rest in the benefit of a negative (normal) result (i.e. >25 mm) which would prevent unnecessary interventions in women who have signs and/or symptoms of preterm labor. The clinical significance of a short cervical length (i.e. <25 mm) remains unclear. Negative predictive values have ranged from 77%-96% and positive predictive values have ranged from 27%-100% for a 25 mm cutoff between 18-28 weeks gestation (Conclusion Grade II).
High-risk patients with changes in their cervical length between 18-28 weeks gestation or with the appearance of a funnel or beak at the internal os that comprises about 40-50% or more of the total cervical length have been shown to be at increased risk of preterm delivery.
Although cervical length measurement between 28-35 weeks gestation may be clinically helpful, its usefulness has not been supported in the literature. Ultrasound measurement of cervical length is not recommended before 14 weeks gestation or after 35 weeks gestation.
Authors' methods:
Review
Details
Project Status:
Completed
URL for project:
http://www.icsi.org/index.asp
Year Published:
2003
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
United States
MeSH Terms
- Obstetric Labor, Premature
- Ultrasonography
Contact
Organisation Name:
Institute for Clinical Systems Improvement
Contact Address:
8009 34th Avenue South, Suite 1200, Bloomington, MN, USA. Tel: +1 952 814 7060; Fax: +1 952 858 9675
Contact Name:
icsi.info@icsi.org
Contact Email:
icsi.info@icsi.org
Copyright:
Institute for Clinical Systems Improvement (ICSI)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.