ORIGINAL ARTICLE

Short cervix, wide anterior cervical angle and low cervical consistency index as a predictor of preterm birth: a case-control study

Andy Susanto, Anak Agung Gede Putra Wiradyana , Ketut Suwiyoga, I Gusti Putu Mayun Mayura, Ida Bagus Fajar Manuaba, I Nyoman Bayu Mahendra, I Wayan Megadhana

Andy Susanto
Resident of Obstetrics and Gynaecology Department, Sanglah General Hospital, Bali, Indonesia

Anak Agung Gede Putra Wiradyana
Obstetrics and Gynaecology Department, Faculty of Medicine, Universitas Udayana-Sanglah General Hospital, Bali, Indonesia. Email: putrawiradnyana@yahoo.com

Ketut Suwiyoga
Obstetrics and Gynaecology Department, Faculty of Medicine, Universitas Udayana-Sanglah General Hospital, Bali, Indonesia

I Gusti Putu Mayun Mayura
Obstetrics and Gynaecology Department, Faculty of Medicine, Universitas Udayana-Sanglah General Hospital, Bali, Indonesia

Ida Bagus Fajar Manuaba
Obstetrics and Gynaecology Department, Faculty of Medicine, Universitas Udayana-Sanglah General Hospital, Bali, Indonesia

I Nyoman Bayu Mahendra
Obstetrics and Gynaecology Department, Faculty of Medicine, Universitas Udayana-Sanglah General Hospital, Bali, Indonesia

I Wayan Megadhana
Obstetrics and Gynaecology Department, Faculty of Medicine, Universitas Udayana-Sanglah General Hospital, Bali, Indonesia
Online First: November 18, 2021 | Cite this Article
Susanto, A., Wiradyana, A., Suwiyoga, K., Mayura, I., Manuaba, I., Mahendra, I., Megadhana, I. 2021. Short cervix, wide anterior cervical angle and low cervical consistency index as a predictor of preterm birth: a case-control study. Bali Medical Journal 10(3): 932-935. DOI:10.15562/bmj.v10i3.2767


Objective: To determine and compare either change in length, anterior angle, and consistency of cervix can be used as the predictors of preterm labor or not.

Methods: This case-control study involved 54 pregnant women with gestational age 20 - 37 weeks, which the case group is women in preterm labor and the control group were not in labor at Sanglah General Hospital, Bali, Indonesia from November 2018 to October 2019. The samples were examined using Transvaginal Sonography (TVS) to collect Cervical Length (CL), Anterior Cervical Angle (ACA), and Cervical Consistency Index (CCI) data.

Results: Short CL could increase the risk of preterm labor by 9 times (OR = 8.80, 95% CI = 2.50-30.97, p-value 0.001). Wide ACA could increase the risk by 10 times (OR = 10.45, CI 95% = 2.92-37.39, p = 0.001). Low CCI could increase the risk by 7 times (OR = 7.43, 95% CI = 1.80-30.67, p = 0.003). Anterior cervical angle has the greatest role in the occurrence of preterm labor, followed by CL and CCI, although statistically insignificant (p=0.138; p=0.212= p:0.203).

Conclusion: Performing cervical examination using TVS as the antenatal care routine can help predict and prevent preterm delivery.

References

Gauthama IMPS, Negara IKS. Characteristics of Preterm Birth Cases at Sanglah Hospital Denpasar (Period from 1 January to 31 December 2016). Int J Sci Res. 2017;6(7):2248–52. Available from: http://dx.doi.org/10.21275/art20175924

Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller A-B, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet. 2012;379(9832):2162–72. Available from: http://dx.doi.org/10.1016/s0140-6736(12)60820-4

Leppert PC. Anatomy and physiology of cervical ripening. Clin Obstet Gynecol. 1995;38(2):267-79. Available from: doi: 10.1097/00003081-199506000-00009.

Berghella V, Palacio M, Ness A, Alfirevic Z, Nicolaides KH, Saccone G. Cervical length screening for prevention of preterm birth in singleton pregnancy with threatened preterm labor: systematic review and meta-analysis of randomized controlled trials using individual patient-level data. Ultrasound Obstet Gynecol. 2017;49(3):322–9. Available from: http://dx.doi.org/10.1002/uog.17388

Sochacki-Wójcicka N, Wojcicki J, Bomba-Opon D, Wielgos M. Anterior cervical angle as a new biophysical ultrasound marker for prediction of spontaneous preterm birth. Ultrasound Obstet Gynecol. 2015;46(3):377–8. Available from: http://dx.doi.org/10.1002/uog.14801

Parra-Saavedra MA, Gómez LA, Barrero A, Parra G, Vergara F, Diaz-Yunez I, et al. Cervical Consistency Index: A New Concept in Uterine Cervix Evaluation. Donald Sch J Ultrasound Obstet Gynecol. 2011;5(4):411–5. Available from: http://dx.doi.org/10.5005/jp-journals-10009-1218

Free Communication Oral Presentation and Early Career Researcher Presentation Abstracts Presented at The Royal Australian and New Zealand College of Obstetricians and Gynaecologists 2011 Annual Scientific Meeting (RANZCOG 2011 ASM) 27-30 November 2011, Me. Aust New Zeal J Obstet Gynaecol. 2011;51(5):472–5. Available from: http://dx.doi.org/10.1111/j.1479-828x.2011.01376.x

Dziadosz M, Bennett T-A, Dolin C, West Honart A, Pham A, Lee SS, 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. Available from: http://dx.doi.org/10.1016/j.ajog.2016.03.033

Andersen HF, Nugent CE, Wanty SD, Hayashi RH. Prediction of risk for preterm delivery by ultrasonographic measurement of cervical length. Am J Obstet Gynecol. 1990;163(3):859–67. Available from: http://dx.doi.org/10.1016/0002-9378(90)91084-p

DeFranco EA, Lewis DF, Odibo AO. Improving the screening accuracy for preterm labor: is the combination of fetal fibronectin and cervical length in symptomatic patients a useful predictor of preterm birth? A systematic review. Am J Obstet Gynecol. 2013;208(3):233.e1-233.e6. Available from: http://dx.doi.org/10.1016/j.ajog.2012.12.015

van Baaren GJ, Vis JY, Wilms FF, Oudijk MA, Kwee A, Porath MM, et al. Predictive Value of Cervical Length Measurement and Fibronectin Testing in Threatened Preterm Labor. Obstet Anesth Dig. 2015;35(2):88–9. Available from: http://dx.doi.org/10.1097/01.aoa.0000463834.31552.e6

Sur B, Misra S, Dash S. Evaluation of the anterior cervical angle of the uterus to predict spontaneous preterm birth. Int J Reprod Contraception, Obstet Gynecol. 2017;6(6):2323. Available from: http://dx.doi.org/10.18203/2320-1770.ijrcog20172114

Farràs Llobet A, Regincós Martí L, Higueras T, Calero Fernández IZ, Gascón Portalés A, Goya Canino MM, et al. The uterocervical angle and its relationship with preterm birth. J Matern Neonatal Med. 2017;31(14):1881–4. Available from: http://dx.doi.org/10.1080/14767058.2017.1331427

Daskalakis G, Theodora M, Antsaklis P, Sindos M, Grigoriadis T, Antsaklis A, 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. Available from: https://pubmed.ncbi.nlm.nih.gov/30687736


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