Soghra Khazardoost - Breastfeeding Research Center, Vali-asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Mahdieh Modarresi - Department of Perinatology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
Masoumeh Shafaat - Department of Perinatology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
Seyedeh Mojgan Ghalandarpoor-Attar - Department of Perinatology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
Seyedeh Mahya Modaresi - Department of Perinatology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran

Background: This study aimed to assess the diagnostic value of novel ultrasonographic markers, Anterior Uterocervical Angle (AUA), Cervical Consistency Index (CCI) and Cervical Glandular Area (CGA) in the Prediction of Preterm Birth (PTB), in a general population. Methods: We conducted a prospective cohort study on singleton gestations between ۱۶ -۲۴ weeks undergoing transvaginal sonography for Cervical Length (CL) screening. AUA, CCI and CGA were evaluated. The primary outcome was prediction of spontaneous PTB before ۳۷ weeks’ gestation by UCA, CCI and CGA. The secondary outcome was evaluating performance of these markers alone and in combination with CL to predict PTB. Results: A total of ۳۱۰ women were studied. The rate of PTB in this population was ۱۰.۶ % for delivery before ۳۷ weeks. In the PTB group, the shorter CL, the wider AUA and the lower CCI were significant, but the CGA width and area were not significantly different in term and PTB groups. The optimal cut-off based on the ROC curve was ۳۳.۱۵ mm for CL (sensitivity: ۵۷%; specificity: ۶۸%), ۱۰۲.۵ degrees for AUA (sensitivity: ۵۰%; specificity: ۸۰%), and ۶۰.۳% for CCI (sensitivity: ۴۳%; specificity: ۶۸%). Conclusions: Our data indicate that the combination of CL and CCI (positive likelihood ratio:۳; negative likelihood ratio:۰.۷) and the combination of CL and AUA (positive likelihood ratio:۴.۸; negative likelihood ratio:۰.۷۶) are better methods for the prediction of spontaneous PTB before ۳۷ weeks; and can be used as a screening tool in the second trimester.

Cervical length measurement, Preterm Birth, Ultrasonography