Uterocervical Angle and Preterm Labour

Study Overview
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Brief Summary
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To determine whether a novel ultrasonographic marker, uterocervical angle, correlates with risk of spontaneous preterm birth

Detailed Description
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The uterocervical angle is the triangular segment measured between the lower uterine segment and the cervical canal, yielding a measurable angle. The first ray was placed from the internal os to the external os. The calipers were placed where the anterior and posterior walls of the cervix touch the internal and external os along the endocervical canal. If the cervix was curved, the first ray was also drawn from the internal os to the external os as a straight line. A second ray was then drawn to delineate the lower uterine segment. This ray was traced up the anterior uterine segment to a distance allowed by the preloaded image. Ideally, the second ray would reach 3cm up the lower uterine segment in order to establish an adequate measurement. The anterior angle in between the two rays was measured with a protractor. In the presence of funneling, the first ray was placed to measure the length of remaining cervix. The second caliper was placed from the innermost portion of measurable cervix and extended to the lower uterine segment. In the event that the lower uterine segment was found to be irregular, the second caliper was placed centrally along the segment. In the event of a retroverted uterus, the angle should be measured in a similar fashion with the first ray along the measurable cervix and the second ray traced along the lower uterine segment. Unlike in an anteverted or axial positioned uterus, however, the posterior side of the angle closer to the intrauterine contents should then be measured.

Official Title
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Relationship Between Uterocervical Angle and Prediction of Spontaneous Preterm Birth

Conditions
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Preterm Labor

Intervention / Treatment
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* Diagnostic Test: Uterocervical angle


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Maternal age (18_40). BMI (20_34). singleton gestations between (18 - 28) weeks. Multiparity. History of previous preterm deliveries or mid-trimesteric abortions. Exclusion Criteria: Loss of follow up. Preterm premature rupture of membranes(PPROM). Placental abnormalities. Past history of cervical operations. Multifetal pregnancy. Polyhydramnios. Steroids intake . Medically or obstetric indicated pregnancy termination. Serious maternal or fetal problems. Cerclage during current pregnancy before the screening.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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Female

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: Uterocervical angle|Transvaginal ultrasound examination will be performed at 18-28 weeks gestation in (197) pregnant women with live singleton fetuses, attending routine prenatal care services. Measuring length of uterine cervix at (18-28) weeks & evaluation of dilatation of internal os & measurement of uterocervical angle between(18-28)weeks gestational age.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Gestational age at birth | Preterm labour is defined as regular contractions of the uterus resulting in changes in the cervix that start before 37 weeks of pregnancy. Changes in the cervix include effacement (the cervix thins out) and dilation (the cervix opens so that the fetus can enter the birth canal). | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Apgar score at 1 and 5 minutes | Appearance (skin color) Pulse (heart rate) Grimace response (reflexes) Activity (muscle tone) Respiration (breathing rate and effort) | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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uterocervical angle, Preterm birth