Düşük riskli gebelerde servikal uzunluğun değerlendirilmesinde transvajinal ve transabdominal ultrason ve mesane doluluğu incelemesi

Investigation of transvaginal and transabdominal ultrasound and bladder fullness in the evaluation of cervical length in low-risk pregnant women

Özet

Amaç: Servikal uzunluk, servikal yetersizli¤i ve preterm do¤umu öngörmede kullan›lan önemli bir ultrasonografi belirtecidir. Bu çal›flmadaki amac›m›z, transabdominal ve transvajinal servikal uzunluklar› üç trimesterde karfl›laflt›rmak ve mesane dolulu¤unun transabdominal ölçümler üzerindeki etkisini araflt›rmakt›. Yöntem: Bu çal›flma, prospektif kesitsel bir çal›flma olarak planland› ve hastaneye baflvuran ve gebeli¤in 11–37. haftalar› aras›nda olan düflük riskli gebeler çal›flmaya dahil edildi. Hastalar trimesterlerine göre üç gruba ayr›ld› ve hastalar›n servikal uzunluklar›, önce dolu ve ard›ndan bofl mesaneyle, önce transabdominal, ard›ndan transvajinal ultrason ile de¤erlendirildi. Bulgular: Ortalama servikal uzunluk birinci trimesterdeki hastalarda 45.6±7.0 cm, ikinci trimesterdeki hastalarda 42.8±7.0 cm ve üçüncü trimesterdeki hastalarda 41.0±8.5 cm olarak ölçüldü. Transvajinal servikal uzunluk üç trimesterde de en uzun olmas›na ra¤men, mesane doluyken transvajinal ve transabdominal ultrason aras›nda istatistiksel olarak anlaml› bir fark bulunmad› (p>0.05). Mesane boflken transabdominal ultrason ile transvajinal ultrason karfl›laflt›r›ld›¤›nda, transvajinal ölçümlerin her trimester istatistiksel olarak anlaml› flekilde daha uzun oldu¤u bulundu (p0.05). Sonuç: Mesane doluyken transabdominal ve transvajinal de¤erlendirme, üç trimesterde de benzer bulunmufltur. Mesane doluyken transabdominal ultrason, düflük riskli hastalarda her trimesterde servikal uzunlu¤u ölçümü için güvenle kullan›labilir.

Abstract

Objective: Cervical length is an important ultrasonographic marker used to predict cervical insufficiency and preterm labor. Our aim in this study was to compare TA and TV cervical lengths in three trimesters and to investigate the effect of bladder fullness on TA measurements. Methods: This study was planned as a prospective cross-sectional study and low-risk pregnant women between 11–37 weeks who presented to the hospital were included in the study. The patients were divided into three groups according to their trimesters, and the cervical lengths of the patients were assessed first with TA and then TV ultrasound with a full bladder and then an empty bladder. Results: The mean cervical length was 45.6±7.0 cm in firsttrimester patients, 42.8±7.0 cm in second-trimester patients, and 41.0±8.5 cm in third-trimester patients. Although TV cervical length was longer in all three trimesters, no statistically significant difference was found between TV and TA ultrasound with a full bladder (p>0.05). When TA ultrasound with empty bladder and TV ultrasound were compared, the TV measurements were found to be statistically significantly longer in each trimester (p0.05). Conclusion: TV and TA assessment with a full bladder were found similar in all three trimesters. TA ultrasound with a full bladder can be safely used for cervical length measurement in low-risk patients in every trimester.