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Predicting onset of labor from echogenicity of the cervical gland area on vaginal ultrasonography at term

  • Michiko Yamaguchi , Tekehiko Fukami , Hirobumi Asakura EMAIL logo and Toshiyuki Takeshita
Published/Copyright: August 19, 2014

Abstract

Background and aim: On vaginal ultrasonography, cervical gland area (CGA) gradually disappears with advancing gestation. This is attributed in part to the echogenicity of the CGA becoming equal to that of the cervical stroma. The present study aimed to assess the usefulness of echogenicity in the CGA at term for predicting the time of spontaneous onset of labor.

Methods: The ratio of mean grayscale level (MGL) in the CGA to that in the cervical stroma (CGA/stroma MGL ratio) was estimated as an index of echogenicity in the CGA in women after 36 weeks of gestation (n=190). Using this ratio, time until onset of labor was predicted among women between 37 and 38 weeks (n=104).

Results: CGA/stroma MGL ratio increased with advancing gestation, decreasing cervical length (CL), and increasing Bishop score. Univariate logistic analysis indicated that a combination of CL<20 mm and CGA/stroma MGL ratio ≥100% predicted onset of labor within a week [odds ratio (OR), 22.2; 95% confidence interval (CI), 2.4–202.0] was even better than short CL alone (OR, 6.8; 95%CI, 1.7–26.7; P=0.006). Stepwise logistic analysis identified that this combination was an only independent predictor (OR, 20.8; 95%CI, 2.3–188.5; P=0.007).

Conclusion: The combination of CGA/stroma MGL ratio ≥100% and short CL may offer a useful predictor of onset of labor.


Corresponding author: Hirobumi Asakura, Department of Obstetrics and Gynecology, Nippon Medical School, Musashi Kosugi Hospital, 1-396 Kosugityo, Nakaharaku, Kawasaki, Kanagawa 211-0063, Japan, Phone: +81-044-733-5181, Fax: +81-044-311-8739, E-mail:

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The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2014-3-5
Accepted: 2014-7-23
Published Online: 2014-8-19
Published in Print: 2015-9-1

©2015 by De Gruyter

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