Digital and ultrasonographic cervical assessment as a predictor of easy induction of midtrimesteric missed abortion

Abstract EN

Objective: Is to compare between the accuracy of digital examination and ultrasonographic assessment of the cervix as predictors of easiness of induction of midtrimestric abortion.

Study design: Observational prospective study.

Setting: Maternity hospitals – Ain Shams University.

Methodology: 48 women were admitted with mid-trimesteric missed abortion planning for induction of abortion to Maternity hospital, Ain Shams University , Cairo, Egypt, between August 2012 to February 2014.With age between 17-40 years, singleton pregnancy and gestational age between 12-26 weeks.

Patients with multiple gestation, medical disorders and previous caesarean sections or uterine surgery were excluded.

Digital examination assessing cervical length, position and consistency was done prior to ultrasonographic assessment.

Ultrasound was performed using an ultrasound machine with 7.5 MHz transducer.

The examination was performed with an empty bladder to avoid elongation of the cervix.

Cervical measurements were taken by the standard technique, a midline sagittal view of the cervix; with the echogenic endocervical mucosa along the length of the canal; was obtained.

Statistical analysis: Statistical analysis was performed using Microsoft Excel version 2010 and Statistical Package for Social Sciences (SPSS) for Windows version 20 Kolmogorov- Smirnov test for normality was applied to all measured variables.

Results: All included women had closed external os, with mean digital cervical length was 2.73 cm.

The mean cervical length measured by TVS was 4.01 cm The mean difference between digital cervical length and cervical length measured by TVS was -1.28 cm; this difference was statistically significant [95% CI (-1.56 to -0.99), p<0.001].

Conclusion: A favourable cervical condition by digital examination is a good predictor to easy induction of midtrimesteric missed abortion.

Transvaginal ultrasonographic cervical measurements don't affect the process of induction of midtrimesteric missed abortion.