"A million-plus induced abortions are performed in the U.S. alone each year. Some studies have demonstrated an increased risk of pre-term birth in women who have had induced abortions," according to lead researcher Dr. Jacquelyn Pelham from Thomas Jefferson University in Philadelphia. Pre-term birth is the leading cause of perinatal mortality, affecting 8% to 10% of births.
The investigators analyzed 43 women with a history of induced abortion by D&C at less than 12 weeks. Patients were prospectively studied with transvaginal cervical ultrasound (TVU) to determine cervical length (CL) between 14-24 weeks. The predictive value of TVU was evaluated using less than 25 mm CL as criteria for the diagnosis of a short cervix. The primary outcome was pre-term birth less than 35 weeks.
Of the 43 women evaluated, 22 (51%) had a short cervix. Of these, eight (36%) had pre-term birth of less than 35 weeks. Of the 21 patients without a short cervix, only two (10%) had a pre-term birth less than 35 weeks.
The researchers found a sensitivity of 80% for cervical TVU for pre-term birth less than 35 weeks. The specificity was 58%, the positive predictive value was 36%, and the negative predictive value was 90%. The relative risk was 3.8 (95% CI 0.9, 16).
"In this population of women already at risk for pre-term birth, we determined that TVU of the cervix is a useful predictor of pre-term birth," Pelham said. The results of this study may lead to increased use of transvaginal ultrasound (TVU) to evaluate a patient’s risk for pre-term birth, possibly allowing for earlier intervention. However, further research may be needed before such a global conclusion is drawn, she added.
By Jerry Ingram and Bruce SylvesterAuntMinnie.com contributing writers
July 4, 2003
Related Reading
Uterine fibroid embolization does not impair fertility, April 1, 2003
First-trimester ultrasound Down screening offers savings -- but at a cost, February 6, 2003
Ultrasound study links uterine fibroids to pregnancy loss, November 14, 2001
Copyright © 2003 AuntMinnie.com
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
