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Obstetrics & Gynecology 2005;105:443
© 2005 by The American College of Obstetricians and Gynecologists
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Letter to the Editor

Repeat Measurement of Cervical Length After Successful Tocolysis

Ken-ichi Shukunami, MD, Koji Nishijima, MD, Yoshio Yoshida, MD and Fumikazu Kotsuji, MD, PhD

Department of Obstetrics and Gynecology, University of Fukui Matsuoka-Cho, Yoshida-Gun, Fukui, Japan

To the Editor:

We read with great interest the article by Rozenberg et al.1 They concluded that repeating ultrasonographic cervical length measurements after successful tocolysis for preterm labor was ineffective. Most studies that have compared manual and ultrasonographic examination of the cervix in their ability to predict premature delivery have supported the use of ultrasonography. However, those studies included low- or middle-risk populations. Volumenie et al,2 who compared digital and ultrasonographic cervical examination for prediction of preterm delivery in patients hospitalized for preterm labor, reported that digital examination using a Bishop score was better than ultrasonography in a high-risk population requiring hospitalization. In Rozenberg's study, subjects were also inferred to be of the high-risk population because the patients were admitted and treated for uterine contractions at 24+0 to 33+6 weeks of gestation and had a cervical length of 26 mm or less by transvaginal ultrasonography. That inference is supported by similar preterm delivery rates found in the Rozenberg and the Volumenie studies. They were 41.3% and 39.0%, respectively.

Volumenie's results imply that systematic ultrasonography after digital examination adds no relevant information to the accurate assessment of threatened preterm labor. Accordingly, in Rozenberg's study, digital examination using the Bishop score should be done before asserting the ineffectiveness of repeat ultrasonographic cervical length measurement, even if it is performed after successful tocolysis for preterm labor.

doi:10.1097/01.AOG.0000153259.48553.96

REFERENCES

1. Rozenberg P, Rudant J, Chevret S, Boulogne AI, Ville Y. Repeat measurement of cervical length after successful tocolysis. Obstet Gynecol 2004;104:995–9.[Abstract/Free Full Text]

2. Volumenie JL, Luton D, Spirlet MD, Sibony O, Blot P, Oury JF. Ultrasonographic cervical length measurement is not a better predictor of preterm delivery than digital examination in a population of patients with idiopathic preterm labor. Eur J Obstet Gynecol Reprod Biol 2004;117:33–7.[Medline]





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