Translabial ultrasound of the third-trimester uterine cervix. Correlation with digital examination.

Abstract

This prospective blinded study compared translabial ultrasound (TLU) and digital palpation of the cervix among women whose cervix could not be visualized adequately or at all with transabdominal ultrasound during the third trimester of pregnancy. The cervical canal and internal cervical os were adequately visualized during 109 of 113 TLUs (96%). The TLU was well tolerated by the patients; only two patients refused the TLU pending discussion of the technique with their obstetrician. Among 43 examinations of patients without clinical cervical effacement, TLU showed a cervical length of 2.5 to 4.2 cm (mean, 2.9 cm). An excellent correlation (R = 0.90) was noted between cervical length on TLU and percentage of cervical effacement on digital examination. The correlation between amount of cervical dilatation on TLU and on digital examination was not high (R = 0.58). We conclude that the measurements of cervical length on TLU correlate well with the amount of cervical effacement on digital examination and that TLU provides a rapid and well-tolerated alternative technique to visualize the third-trimester uterine cervix.