The association between urethral configuration and mobility and female stress urinary incontinence investigated by transperineal ultrasound / 中华超声影像学杂志

Objective:To study the association between urethral configuration and mobility and female stress urinary incontinence (SUI).Methods:This was a prospective study in 176 women with pure SUI and 132 healthy women who undertook transperineal ultrasound in Second Xiangya Hospital between July 2017 and April 2020. Urethral funneling, bladder neck descent (BND) and rotation, retrovesical angle (RVA), and urethral mobility of 6 points along the urethra (Vectors 1 to 6) were measured by transperineal ultrasound during the cough stress test (CST). The differences between the two groups were tested using independent t-test. The relationship between ultrasound findings and SUI was analyzed by ROC curve and Logistic regression analysis. Results:Urethral funneling was found in 27.8% of women with SUI and 3.0% of controlled women.BND [(25.2±7.4)mm vs (21.5±8.6)mm], RVA [(171.5±26.3)° vs (159.4±26.6)°] and Vectors 1-6 [(2.97±0.89), (2.93±0.75), (2.67±0.67), (2.34±0.66), (2.27±0.67) , (2.36±0.69) vs (2.59±1.03), (2.54±0.83), (2.27±0.64), (1.99±0.50), (1.94±0.49), (2.05±0.53)] were significantly increased in SUI group (all P≤0.001). Logistic regression analysis yielded odds ratios of 10.06(95% CI=4.18-24.20), 2.71(95% CI=1.81-4.05) and 3.21(95% CI=2.01-5.14) for urethral funneling, Vector 3 and Vector 4 to predict for SUI, respectively. Conclusions:Transperineal ultrasound can be used to evaluate the real-time change of the bladder neck and urethral configuration and mobility in CST. Urethral funneling and mid-urethral hypermobility can be used to predict SUI.

Cervical Evaluation By Transvaginal Ultrasonography as a Predictor of Preterm Labour

Aims and Objective:  To determine the efficacy of TVS ultrasonographic evaluation of cervical biometry in predicting preterm delivery in asymptomatic low risk pregnant women. Material and Methods - a prospective analysis of low- risk pregnant patients at 22-24 weeks attending antenatal OPD at a tertiary level teaching hospital over a period of one year. There were 200 antenatal patients overall equally divided into two groups GrA with 100 patients and cervical length< 2.5cm and GrB with 100 patients having cervical length >/= 2.5cm. Transvaginal ultrasonography was performed and cervical evaluation done by measuring cervical length and recording presence or absence of funnelling. These women were followed till delivery and results analysed by finding p-value. Results: The results proved that with cervical length, 2.5cm the preterm deliveries were 88% while term deliveries were only 12%. This was statistically significant with a P-value of < 0.001. Of the 88 patients that had preterm delivery, in 36 patients there was presence of funneling and only 2 of these could carry their pregnancies till term and 34 of them ie.  94.4% had preterm deliveries. In patients with cervical length >/= 2.5cm the total preterm delivery rate was only 8% in asymptomatic pregnant women and the term deliveries were 92%. Of the Preterm deliveries in this group 2 (25%) had funneling while in 6 (75%) it was absent. Conclusion: This study has re-established the relevance of TVS in cervical assessment for prediction of preterm labour.

Sonographically accessed funneling of the uterine cervix as a predictor of successful labor induction

OBJECTIVE: The Bishop score and length of the uterine cervix are good predictors of successful labor induction. However, little is known about the association between the funneling of the uterine cervix and successful labor induction. The study aimed to evaluate cervical funneling as a predictor of successful labor induction. METHODS: This study was designed as a prospective observational study. Subjects who delivered a baby by labor induction were enrolled in the study from July 2011 to August 2013. Cervical funneling and length were examined with transvaginal ultrasonography. The Bishop score was rated by digital pelvic examination. RESULTS: A total of 163 primigravida women were recruited for the study. Of these, 137 participants (84.0%) delivered vaginally by labor induction. Cervical funneling was observed in 93 women (57.1%). Successful labor induction was significantly higher in patients with cervical funneling than those without it (91.4% vs. 74.3%, P<0.01), and was significantly associated with cervical funneling, as well as the Bishop score and cervical length. In a multivariate analysis, cervical funneling was an independent predictor for successful vaginal delivery by labor induction ( odd ratio, 2.70; 95% confidence interval, 1.02 to 7.10; P=0.04). However, the Bishop score and cervical length had no association with successful vaginal delivery. CONCLUSION: This study showed that cervical funneling could be a predictive marker for vaginal delivery during labor induction.

Sonographically accessed funneling of the uterine cervix as a predictor of successful labor induction

OBJECTIVE: The Bishop score and length of the uterine cervix are good predictors of successful labor induction. However, little is known about the association between the funneling of the uterine cervix and successful labor induction. The study aimed to evaluate cervical funneling as a predictor of successful labor induction. METHODS: This study was designed as a prospective observational study. Subjects who delivered a baby by labor induction were enrolled in the study from July 2011 to August 2013. Cervical funneling and length were examined with transvaginal ultrasonography. The Bishop score was rated by digital pelvic examination. RESULTS: A total of 163 primigravida women were recruited for the study. Of these, 137 participants (84.0%) delivered vaginally by labor induction. Cervical funneling was observed in 93 women (57.1%). Successful labor induction was significantly higher in patients with cervical funneling than those without it (91.4% vs. 74.3%, P<0.01), and was significantly associated with cervical funneling, as well as the Bishop score and cervical length. In a multivariate analysis, cervical funneling was an independent predictor for successful vaginal delivery by labor induction ( odd ratio, 2.70; 95% confidence interval, 1.02 to 7.10; P=0.04). However, the Bishop score and cervical length had no association with successful vaginal delivery. CONCLUSION: This study showed that cervical funneling could be a predictive marker for vaginal delivery during labor induction.

Prediction of an actual birth within one week by ultrasonographic examination at 38 weeks' of gestation / 대한산부인과학회지

OBJECTIVE: The aim of this study is to predict spontaneous labor onset delivery within 7 days in low risk pregnant women at 38 weeks' of gestation by ultrasonographic examination of cervical changes. MATERIAL AND METHODS: This prospective study included 110 singleton low risk pregnancies between 37(+0) and 37(+6) weeks of gestation. Fifteen cases were lost during follow-up and finally 95 pregnant women (58 nulliparous, 37 multiparous) were analysed. The study period was from Oct/2005 to May/2007. Four cervical changes (length, gland thickness, funneling and canal formation) were evaluated. Main outcome was remaining day to delivery after the examination. Remaining days to actual delivery with spontaneous labor onset were recorded and the pregnancies were divided into two groups according to remaining days (within 7 days, over 7 days) to compare predicting power of delivery within 7 days. ROC curves were drawn to find out cut-off values of cervical length and gland thickness. Sensitivity, specificity, positive predictive value and negative predictive value were extracted from four cervical changes. RESULTS: Mean cervical length of pregnant women at 38 weeks' of gestation was 25.8 (+/-10.0) mm and mean cervical gland thickness was 4.3 (+/-1.2) mm. Funnelings of uterine cervix were detected in 13 cases (13.7%), canal formations in 6 cases (6.3%). All four cervical changes were statistically valuable to predict delivery within 7 days and the cervical length showed highest sensitivity. When the cervical length was measured under 20 mm, the possibility of delivery within 7 days was 78.6% (p<0.001). The cervical gland thickness less than 4 mm could predict the delivery within 7 days with sensitivity of 57.1% (p<0.01). Sensitivities of funneling and canal formation for delivery within 7 days were 54.5%, 36.4% each. CONCLUSION: Ultrasonographic examination of the cervical changes in low risk singleton pregnancy at 38 weeks' of gestation are valuable for predicting spontaneous labor onset delivery within 7 days. Among four cervical changes, cervical length is most sensitive ultrasonographic marker.