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CC BY 4.0 · Rev Bras Ginecol Obstet 2020; 42(09): 540-546
DOI: 10.1055/s-0040-1713010
Original Article
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Women's Obstetric History and Midtrimester Cervical Length Measurements by 2D/3D and Doppler Ultrasound

História obstétrica e medida do comprimento do colo uterino de mulheres no segundo trimestre gestacional por ultrassonografia bi/tridimensional e Doppler
Juliana Valente Codato Marinelli 
1   Obstetric Clinic Division, Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
,
Antonio Gomes de Amorim Filho 
1   Obstetric Clinic Division, Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
,
Monica Fairbanks de Barros 
1   Obstetric Clinic Division, Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
,
Agatha Sacramento Rodrigues 
2   Obstetrics Discipline, Department of Obstetrics and Gynecology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
,
Rossana Pulcineli Vieira Francisco 
2   Obstetrics Discipline, Department of Obstetrics and Gynecology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
,
Mario Henrique Burlacchini de Carvalho 
2   Obstetrics Discipline, Department of Obstetrics and Gynecology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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Abstract

Objective The aim of the present study was to compare the obstetric history and both two- and tri-dimensional ultrasound parameters according to different cervical lengths.

Methods The present cross-sectional study analyzed 248 midtrimester pregnant women according to cervical length and compared the data with the obstetric history and 2D/3D ultrasound parameters. Patients were divided into 3 groups according to cervical length: The Short Cervix group for cervical lengths ≥ 15 mm and < 25 mm (n = 68), the Very Short Cervix group for cervical lengths < 15 mm (n = 18) and the Control group, composed of 162 pregnant women with uterine cervical lengths ≥ 25 mm.

Results When analyzing the obstetric history of only non-nulliparous patients, a significant association between the presence of a short cervix in the current pregnancy and at least one previous preterm birth was reported (p = 0.021). Cervical length and volume were positively correlated (Pearson coefficient = 0.587, p < 0.0001). The flow index (FI) parameter of cervical vascularization was significantly different between the Control and Very Short Cervix groups. However, after linear regression, in the presence of volume information, we found no association between the groups and FI. Uterine artery Doppler was also not related to cervical shortening.

Conclusion The present study showed a significant association between the presence of a short cervix in the current pregnancy and at least one previous preterm birth. None of the vascularization indexes correlate with cervical length as an independent parameter. Uterine artery Doppler findings do not correlate with cervical length.

Resumo

Objetivo O objetivo do presente estudo foi comparar a história obstétrica e os parâmetros bi- e tridimensionais ultrassonográficos de acordo com os diferentes comprimentos cervicais.

Métodos O presente estudo transversal analisou 248 gestantes no segundo trimestre de acordo com o comprimento cervical e comparou os dados com a história obstétrica e os parâmetros ultrassonográficos 2D/3D. As pacientes foram divididas em 3 grupos de acordo com o comprimento do colo uterino: grupo Colo Curto para comprimentos cervicais ≥ 15 mm e < 25 mm (n = 68), grupo Colo Muito Curto para comprimentos cervicais < 15 mm (n = 18) e grupo Controle, composto por 162 gestantes com comprimento cervical uterino ≥ 25 mm.

Resultados Ao analisar a história obstétrica apenas de pacientes não nulíparas, foi relatada uma associação significativa entre a presença de colo uterino curto na gravidez atual e pelo menos um episódio de parto prematuro anterior (p = 0,021). Comprimento e volume do colo uterino foram correlacionados positivamente (coeficiente de Pearson = 0,587, p < 0,0001). O parâmetro índice de fluxo (IF) da vascularização cervical foi significativamente diferente entre os grupos Controle e Colo Muito Curto. Entretanto, após regressão linear, na presença de informações de volume, não encontramos associação entre os grupos e o parâmetro IF. Também não foi encontrada relação entre o Doppler da artéria uterina e o encurtamento cervical.

Conclusão O presente estudo mostrou uma associação significativa entre a presença de colo uterino curto na gravidez atual e pelo menos um episódio de parto prematuro anterior. Nenhum dos índices de vascularização se correlaciona com o comprimento cervical como parâmetro independente, assim como o Doppler da artéria uterina também não está relacionado ao comprimento do colo uterino.

Keywords

cervix uteri - cervical length measurement - pregnancy trimester, second - reproductive history - pregnancy, high-risk

Palavras-chave

colo do útero - medida do comprimento cervical - segundo trimestre da gravidez - história reprodutiva - gravidez de alto risco

Contributors

All authors were involved in the design and interpretation of the analyses, contributed to the writing of the manuscript, read and approved the final manuscript.




Publikationsverlauf

Eingereicht: 04. Februar 2020

Angenommen: 23. April 2020

Artikel online veröffentlicht:
23. Juni 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Thieme Revinter Publicações Ltda
Rio de Janeiro, Brazil

 

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