Digital examination and transvaginal scan – competing or complementary for predicting preterm birth?

Eva Reiter, Kurt Aagaard Nielsen, Jens Fedder

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

    Resumé

    Background. The transvaginal ultrasonographic cervix scan has partly replaced digitalexamination for diagnosing pretermbirth; conflicting results are reported about their respective contribution to birth prediction. Objective. To review the predictive value of digital examination and transvaginal scan in low-risk asymptomatic and symptomatic women before treatment. Methods. A literature search of PubMed, Web of Science and Cochrane Databases from 1994 to 2010 and selected reference lists was carried out. Randomized controlled trials, retrospective and prospective cohort studies, outcomeresearch and studies of clinical decision ruleswere included.

    Results. The studies showed that methods for the estimation of cervical ripening are not unequivocal nor is the nomenclature for digital examination. Evidence for routine screening for premature cervical ripening in asymptomatic low-risk women is insufficient. Knowledge of ultrasonographic cervical length in symptomatic women was not associated with a significantly improved outcome in symptomatic women, but may help to reduce length of hospitalization. In women selected by the Bishop Score, a transvaginal scan may reduce the number of false-positive results.
    Conclusions. Clarification on the methods for performing cervical assessment is needed. The evidence that transvaginal scanning of the cervix improves outcome in symptomatic women is insufficient. The methods for assessing cervical change should be regarded as complementary.
    OriginalsprogEngelsk
    TidsskriftActa Obstetricia et Gynecologica Scandinavica
    Vol/bind91
    Udgave nummer4
    Sider (fra-til)428-438
    Antal sider10
    ISSN0001-6349
    DOI
    StatusUdgivet - apr. 2012

    Emneord

    • Vaginal examination
    • transvaginal scan

    Citer dette

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    title = "Digital examination and transvaginal scan – competing or complementary for predicting preterm birth?",
    abstract = "Background. The transvaginal ultrasonographic cervix scan has partly replaced digitalexamination for diagnosing pretermbirth; conflicting results are reported about their respective contribution to birth prediction. Objective. To review the predictive value of digital examination and transvaginal scan in low-risk asymptomatic and symptomatic women before treatment. Methods. A literature search of PubMed, Web of Science and Cochrane Databases from 1994 to 2010 and selected reference lists was carried out. Randomized controlled trials, retrospective and prospective cohort studies, outcomeresearch and studies of clinical decision ruleswere included.Results. The studies showed that methods for the estimation of cervical ripening are not unequivocal nor is the nomenclature for digital examination. Evidence for routine screening for premature cervical ripening in asymptomatic low-risk women is insufficient. Knowledge of ultrasonographic cervical length in symptomatic women was not associated with a significantly improved outcome in symptomatic women, but may help to reduce length of hospitalization. In women selected by the Bishop Score, a transvaginal scan may reduce the number of false-positive results. Conclusions. Clarification on the methods for performing cervical assessment is needed. The evidence that transvaginal scanning of the cervix improves outcome in symptomatic women is insufficient. The methods for assessing cervical change should be regarded as complementary.",
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    author = "Eva Reiter and Nielsen, {Kurt Aagaard} and Jens Fedder",
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    Digital examination and transvaginal scan – competing or complementary for predicting preterm birth? / Reiter, Eva; Nielsen, Kurt Aagaard; Fedder, Jens .

    I: Acta Obstetricia et Gynecologica Scandinavica, Bind 91, Nr. 4, 04.2012, s. 428-438.

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

    TY - JOUR

    T1 - Digital examination and transvaginal scan – competing or complementary for predicting preterm birth?

    AU - Reiter, Eva

    AU - Nielsen, Kurt Aagaard

    AU - Fedder, Jens

    PY - 2012/4

    Y1 - 2012/4

    N2 - Background. The transvaginal ultrasonographic cervix scan has partly replaced digitalexamination for diagnosing pretermbirth; conflicting results are reported about their respective contribution to birth prediction. Objective. To review the predictive value of digital examination and transvaginal scan in low-risk asymptomatic and symptomatic women before treatment. Methods. A literature search of PubMed, Web of Science and Cochrane Databases from 1994 to 2010 and selected reference lists was carried out. Randomized controlled trials, retrospective and prospective cohort studies, outcomeresearch and studies of clinical decision ruleswere included.Results. The studies showed that methods for the estimation of cervical ripening are not unequivocal nor is the nomenclature for digital examination. Evidence for routine screening for premature cervical ripening in asymptomatic low-risk women is insufficient. Knowledge of ultrasonographic cervical length in symptomatic women was not associated with a significantly improved outcome in symptomatic women, but may help to reduce length of hospitalization. In women selected by the Bishop Score, a transvaginal scan may reduce the number of false-positive results. Conclusions. Clarification on the methods for performing cervical assessment is needed. The evidence that transvaginal scanning of the cervix improves outcome in symptomatic women is insufficient. The methods for assessing cervical change should be regarded as complementary.

    AB - Background. The transvaginal ultrasonographic cervix scan has partly replaced digitalexamination for diagnosing pretermbirth; conflicting results are reported about their respective contribution to birth prediction. Objective. To review the predictive value of digital examination and transvaginal scan in low-risk asymptomatic and symptomatic women before treatment. Methods. A literature search of PubMed, Web of Science and Cochrane Databases from 1994 to 2010 and selected reference lists was carried out. Randomized controlled trials, retrospective and prospective cohort studies, outcomeresearch and studies of clinical decision ruleswere included.Results. The studies showed that methods for the estimation of cervical ripening are not unequivocal nor is the nomenclature for digital examination. Evidence for routine screening for premature cervical ripening in asymptomatic low-risk women is insufficient. Knowledge of ultrasonographic cervical length in symptomatic women was not associated with a significantly improved outcome in symptomatic women, but may help to reduce length of hospitalization. In women selected by the Bishop Score, a transvaginal scan may reduce the number of false-positive results. Conclusions. Clarification on the methods for performing cervical assessment is needed. The evidence that transvaginal scanning of the cervix improves outcome in symptomatic women is insufficient. The methods for assessing cervical change should be regarded as complementary.

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    KW - transvaginal scan

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    JO - Acta Obstetricia et Gynecologica Scandinavica

    JF - Acta Obstetricia et Gynecologica Scandinavica

    SN - 0001-6349

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