open access
Anterior uterocervical angle: is it an ultrasonographic screening tool that estimates the latent phase duration in post term pregnancies?
Affiliations- University of Health Sciences School of Medicine Bursa Yuksek Ihtisas Research and Training Hospital, Department of Obstetrics and Gynecology, Bursa, Turkey
- Department of Obstetrics and Gynecology, Division of Perinatology, Konya City Hospital, Konya, Turkey
- University of Health Sciences School of Medicine Bursa City Hospital, Department of Obstetrics and Gynecology, Bursa, Turkey
open access
Abstract
Objectives: In recent years, in addition to cervical length measurement, a new ultrasonographic parameter has been defined as uterocervical angle (UCA), which can be used in the prediction of preterm labor. In this study,we evaluated the place of uterocervical angle in predicting the latent phase duration in postterm pregnancies. Material and methods: This prospective study consists of 90 pregnant women aged between 18 to 40 years who were hospitalized with a diagnose of late term pregnancy. Pregnant women with a latent phase duration of 1200 minutes or less were defined as Group 1. Patients with latent phase duration over 1200 minutes were defined as Group 2. All patients’ age, BMI, smoke, cervical length measurements, uterocervical angle, latent and active phase of labor durations, length of the third stage and delivery types were compared. Results: The UCA median value of group 1 was 120 (94–147), and group 2 was 99 (94–105) (p < 0.001). CL medians of Groups 1 and 2 were 29 (17–43) and 28 (27–41) respectively (p: 0.871). UCA (AUC: 0.917, p < 0.0001) significantly predicted prolonged latent phase duration. Optimal cut off value was obtained at the value of 105 degree (100% sensitivity, 75% specificity) for UCA. Kaplan-Meier survival analysis showed that duration of labor was significantly higher in a group with low UCA (p: 0.013). Discussion: UCA can be a successful tool that can be used to predict duration of labor in cases of postterm pregnancies with medical induction.
Abstract
Objectives: In recent years, in addition to cervical length measurement, a new ultrasonographic parameter has been defined as uterocervical angle (UCA), which can be used in the prediction of preterm labor. In this study,we evaluated the place of uterocervical angle in predicting the latent phase duration in postterm pregnancies. Material and methods: This prospective study consists of 90 pregnant women aged between 18 to 40 years who were hospitalized with a diagnose of late term pregnancy. Pregnant women with a latent phase duration of 1200 minutes or less were defined as Group 1. Patients with latent phase duration over 1200 minutes were defined as Group 2. All patients’ age, BMI, smoke, cervical length measurements, uterocervical angle, latent and active phase of labor durations, length of the third stage and delivery types were compared. Results: The UCA median value of group 1 was 120 (94–147), and group 2 was 99 (94–105) (p < 0.001). CL medians of Groups 1 and 2 were 29 (17–43) and 28 (27–41) respectively (p: 0.871). UCA (AUC: 0.917, p < 0.0001) significantly predicted prolonged latent phase duration. Optimal cut off value was obtained at the value of 105 degree (100% sensitivity, 75% specificity) for UCA. Kaplan-Meier survival analysis showed that duration of labor was significantly higher in a group with low UCA (p: 0.013). Discussion: UCA can be a successful tool that can be used to predict duration of labor in cases of postterm pregnancies with medical induction.
Keywords
uterocervical angle; postterm; cervical length
About this articleTitle
Anterior uterocervical angle: is it an ultrasonographic screening tool that estimates the latent phase duration in post term pregnancies?
Journal
Issue
Article type
Research paper
Published online
2023-02-10
Page views
36
Article views/downloads
28
DOI
10.5603/GP.a2022.0126
Pubmed
Keywords
uterocervical angle
postterm
cervical length
Authors
Nefise Nazli Yenigul
Fedi Ercan
Hakan Sager
Elif Yuce Bilgin
Emin Ustunyurt
References (17)- Puertas A, Góngora J, Valverde M, et al. Cardiotocography alone vs. cardiotocography with ST segment analysis for intrapartum fetal monitoring in women with late-term pregnancy. A randomized controlled trial. Eur J Obstet Gynecol Reprod Biol. 2019; 234: 213–217.
- Eser A, Ozkaya E. Uterocervical angle: an ultrasound screening tool to predict satisfactory response to labor induction. J Matern Fetal Neonatal Med. 2020; 33(8): 1295–1301.
- Khalifa MA, Abbas AM, Gaber MA, et al. Bishop score versus transvaginal ultrasonographic measurement of cervical length in predicting successful labor induction in post-termpregnancy: prospectivecohortstudy. Int J Reprod Contracept Obstet Gynecol. 2018; 7(11): 4647–4651.
- Alanwar A, Hussein SH, Allam HA, et al. Transvaginal sonographic measurement of cervical length versus Bishop score in labor induction at term for prediction of caesarean delivery. J Matern Fetal Neonatal Med. 2021; 34(13): 2146–2153.
- Dziadosz M, Bennett TA, Dolin C, et al. Uterocervical angle: a novel ultrasound screening tool to predict spontaneous preterm birth. Am J Obstet Gynecol. 2016; 215(3): 376.e1–376.e7.
- Daskalakis G, Theodora M, Antsaklis P, et al. Assessment of uterocervical angle width as a predictive factor of preterm birth: a systematic review of the literature. Biomed Res Int. 2018; 2018: 1837478.
- Farràs Llobet A, Regincós Martí L, Higueras T, et al. The uterocervical angle and its relationship with preterm birth. J Matern Fetal Neonatal Med. 2018; 31(14): 1881–1884.
- Sepúlveda-Martínez A, Díaz F, Muñoz H, et al. Second-trimester anterior cervical angle in a low-risk population as a marker for spontaneous preterm delivery. Fetal Diagn Ther. 2017; 41(3): 220–225.
- Dagdeviren E, Aslan Çetin B, Aydogan Mathyk B, et al. Can uterocervical angles successfully predict induction of labor in nulliparous women? Eur J Obstet Gynecol Reprod Biol. 2018; 228: 87–91.
- Rooth G. Guidelines for the use of fetal monitoring – FIGO News. Int J Gynecol Obstet. 1987; 25: 159–67.
- Cunningham, F. G., MacDonald, P. C., Gant, N. F. Obstetri Williams. EGC. 2014.
- COG practice bulletin no. 107: induction of labor. Obstet Gynecol. 2009; 114(2 pt 1): 386–397.
- American College of Obstetrics, Gynecology Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin Number 49, December 2003: dystocia and augmentation of labor. Obstet Gynecol. 2003; 102(6): 1445–1454.
- Rota A, Antolini L, Colciago E, et al. Timing of hospital admission in labour: latent versus active phase, mode of birth and intrapartum interventions. A correlational study. Women Birth. 2018; 31(4): 313–318.
- Al-Adwy AM, Sobh SM, Belal DS, et al. Diagnostic accuracy of posterior cervical angle and cervical length in the prediction of successful induction of labor. Int J Gynaecol Obstet. 2018; 141(1): 102–107.
- Abdelhafeez MA, Elguindy AE, Hamed MA, et al. Transvaginal sonographic assessment of the cervix for prediction of successful induction of labor in nulliparous women. Open J Obstet Gynecol. 2020; 10(7): 892–901.
- Gül DK. Can uterocervical angle and cervical length determine the success of induction of labor in late-termand post-term nulliparous pregnant women? Cukurova Med J. 2020; 45(4): 1634–1643.
