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Am J Perinatol 2012; 29(07): 527-532
DOI: 10.1055/s-0032-1310524
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Reliability of Two-Dimensional Transvaginal Sonographic Measurement of Lower Uterine Segment Thickness Using Video Sequences

Amélie Boutin
1   Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Québec, Canada
,
Nicole Jastrow
2   Department of Obstetrics and Gynecology, Faculty of Medicine, Hôpitaux Universitaire de Genève, Université de Genève, Genève, Switzerland
,
Mario Girard
3   Centre de Recherche du Centre Hospitalier Universitaire de Québec, Québec, Canada
,
Stéphanie Roberge
1   Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Québec, Canada
,
Nils Chaillet
4   Department of Obstetrics and Gynecology, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
,
Normand Brassard
5   Department of Obstetrics and Gynecology, Faculty of Medicine, Université Laval, Québec, Canada
,
Emmanuel Bujold
1   Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Québec, Canada
3   Centre de Recherche du Centre Hospitalier Universitaire de Québec, Québec, Canada
5   Department of Obstetrics and Gynecology, Faculty of Medicine, Université Laval, Québec, Canada
› Author Affiliations
Further Information

Publication History

01 November 2011

17 December 2011

Publication Date:
11 April 2012 (online)

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Abstract

Objectives To report the intra- and interobserver reliability of measurement of the lower uterine segment (LUS) thickness using transvaginal sonographic videos.

Methods A prospective study of 60 women with previous, low-transverse cesarean undergoing LUS examination (36 to 39 weeks) was performed. Two observers independently measured full LUS thickness using transvaginal sonography. A video of the LUS was recorded and analyzed more than 2 months later by both observers. Intra- and interobserver reliability was assessed with median absolute differences and interquartile range (IQR), nonparametric limits of agreement, intraclass correlation coefficients (ICC) with 95% confidence interval (95% CI), and kappa coefficients.

Results Median full LUS thickness was 3.6 mm (range: 0.9 to 8.0 mm). Intraobserver repeatability was excellent (median difference: 0.2 mm, IQR: 0.1 to 0.4; ICC: 0.94, 95% CI: 0.90 to 0.96; kappa: 1.00). Interobserver (median difference: 0.3 mm, IQR: 0.2 to 1.3; ICC: 0.91, 95% CI: 0.86 to 0.95; kappa: 0.76, 95% CI: 0.54 to 0.98) and intermethod reproducibility (median difference: 0.4 mm, IQR: 0.2 to 0.8; ICC: 0.82, 95% CI: 0.72 to 0.89; kappa: 0.69, 95% CI: 0.43 to 0.94) were good. However, both interobserver and intermethod reproducibility were improved when LUS thickness was below 3 mm.

Conclusion Full LUS thickness measured from transvaginal sonographic videos has excellent intra- and interobserver reproducibility and good reproducibility with live transvaginal ultrasound.

Keywords

pregnancy - ultrasound - cesarean - lower uterine segment - intraobserver agreement - interobserver agreement - intermethod agreement - reliability - two-dimensional ultrasound
 

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