[Transvaginal ultrasound of the cervix in the estimation of severity of premature labour].

AIM: Premature labour is a frequent situation,it complicates about 6% of births, with increasing perinatal morbidity and mortality. The purpose of this study is to analyse the place of the ultrasound of the cervix in the coverage of a premature labour and the evaluation of the severity of the premature labour, being able to have therapeutic implications.

METHODS

It is about a prospective study 56 patients presenting a premature labour between 28 and 34 weeks realized in the service of maternity in Momgi Slim hospital of Marsa for a period of 12 months going from January 2006 till January 2007.

RESULTS

In our study 56 patients presented an ultrasonographic cervical length < or = 25mm. The funneling was found in 30 patients. The sensibility of the mesure of length of the cervix < or = 25mm to predict the delivery before 48 hours was 100% and specificity was 59%. Negative predictive value of this exam was very strong of 100% and its positive predictive value was 28%. The presence of funneling had a sensibility and a negative predictive value less important by report than that of the mesure of cervical length. The evaluation of severity of premature labour by the vaginal touch and calculation of Bishop's score, is a simple and reproducible exam having the same efficiency as ultrasonographic cervical length.

CONCLUSION

Vaginal touch constitutes essential exam for the diagnosis of severity of the premature labour by basing itself on the calculation of Bishop's score. The utility of the ultrasonographic cervical length is based on its excellent negative predictive value consolidating our therapeutic strategy.