Abstract
Author(s): Amr Sobhy*, Suzy Abdel Aziz and Mohamed I. Taema
Background: Preterm Premature Rupture of Membranes (PPROM) is a primary factor in Preterm Labor (PTL). Assessing the angle between the cervix and uterus may be necessary in predicting PTL. The study aims to evaluate the precision of cervical length and the posterior and anterior cervical angles in forecasting the latency in PPROM.
Design: A cohort Prospective study on 140 patients with PPROM was done in 2 private hospitals in KSA from March 2021 to March 2022. The Primary outcome was the latency period, defined as the period from PPROM till the occurrence of labor. In contrast, the Secondary Outcomes were ultrasonographic measurements of Cervical Length (CL), Anterior and posterior cervical angles, and other relevant obstetric outcomes.
Methods: Patients with PPROM underwent a transvaginal ultrasound examination to measure the Cervical Length (CL) and posterior and anterior uterocervical angle.
Results: The latency period was within two days in 39 patients (27.9%) and after two days in 101 (72.1%) cases. The CL was 24.18 ± 3.88mm vs. 26.66 ± 3.42mm (p-value<0.001). After two days, the posterior uterocervical angle was 113.64 ± 5.15 vs. 108.88 ± 4.62 (p-value<0.001). The anterior uterocervical angle was 113.43 ± 5.68, vs. 106.55 ± 4.83 (p-value<0.001). The cervical length cut-off value of 24mm resulted in 80.3% sensitivity and 67.9% specificity. The posterior uterocervical angle cut-off value of 107.0? yielded a sensitivity of 94.8% and a specificity of 62.8%. In comparison, an anterior uterocervical angle cut-off value of 105? resulted in a sensitivity of 93.9% and a specificity of 74%. An anterior uterocervical angle of ≥ 105? demonstrated the highest diagnostic value for predicting a latency period within two days.
Conclusion: Cervical dimensions and cervical angles measurements have predictive value for the latency period in women with PPROM.