Comparison of reliability between uterocervical angle and cervical length measurements by various experienced operators using transvaginal ultrasound.

Purpose: To compare the reliability between uterocervical angle (UCA) and cervical length (CL) measurements by various experienced operators.

Methods

Transvaginal ultrasonographies (TVS) were performed in 102 pregnant women between 16°/7-24°/7 gestational weeks by different levels of experienced operators. For both CL and UCA measurements, intraobserver variability was assessed for each operator by examining the range between maximum and minimum measurements in each participant, compared to the mean of all three measurements. Interobserver variabilities were explored using Bland-Altman analysis. Intraclass correlation coefficients were used for both intraobserver and interobserver reliability.

Results

For intraobserver variability of the UCA, the ranges between maximum and minimum UCA measurements in operator 1 and 3 were 1.5º-34º and 2º-36º (n = 51), and in operators 2 and 3 were 0º-61º and 1º-25º (n = 51). Intraclass correlation coefficients (ICC) for intraobserver reliability were 0.90 for operator 1, 0.67 for operator 2 and 0.93 for operator 3. For interobserver variability of the UCA, the limits of agreement for mean UCA were -37.53º-38.41º and -36.27º-26.17º, and for maximum UCA were -39.47º-41.38º and -44.24º-22.9º in comparisons between operators 1 and 3, and operator 2 and 3, respectively. Intraclass correlation coefficients for mean UCA were 0.73 and 0.74, and for maximum UCA were 0.71 and 0.67 in comparisons between operators 1 and 3, and operator 2 and 3, respectively.

Conclusions

The UCA measurements had a higher intra- and interobserver reliabilities than the CL measurements.