TITLE:
Vaginal Touch versus Transvaginal Ultrasound in the Management of Threatened Preterm Labour at the University Hospital Center of Porto-Novo (Benin)
AUTHORS:
Ogourinde Mathieu Ogoudjobi, Christiane Tshabu-Aguemon, Megnisse S. H. S. Lokossou, M. Veronique Tognifode, Moufalilou Aboubakar, Gounou Didier Komongui, Joseph Lanwassonou, Angéline Tonato Bagnan, Antoine Lokossou, Issifou Takpara, René-Xavier Perrin
KEYWORDS:
Threat of Preterm Delivery, Vaginal Touch, Transvaginal Ultrasound, Comparison
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.7 No.11,
October
27,
2017
ABSTRACT: Objective: To evaluate the risk of preterm delivery with
vaginal touch in opposition with transvaginal ultrasound in pregnant women who
present signs and symptoms of threatened preterm labour. Methods: A
prospective study was conducted with descriptive and comparative aims at the
University Hospital of Porto-Novo, Benin Republic between 1 March and 31 August 2016. Every pregnant woman
admitted to the emergencies of the maternity between 28 and 34 of WA (weeks of
amenorrhoea) and attended for preterm delivery risk with intact membranes was
included. The risk of preterm delivery was evaluated using vaginal touch and
ultrasound examination of cervical length. Results: The risk of preterm
delivery was obvious and identical with the cervical dilatation ≥2 cm when the
vaginal touch was applied [RR 2.34 IC 95% (1.71 - 3.20)] and ultrasound examination of cervical length
- 4.16)]. The cervix obliteration was not
statistically linked to preterm delivery. The ultrasound examination of
cervical length had a better sensitivity (87.76%) and a negative predictive
value (81.54%) against 59.18% and 74.68% respectively for cervical dilatation
at vaginal touch. Bishop score also had a better specificity with the one of
the ultrasound examination of cervical length (79.11% vs. 33.54%) whereas both of them had almost identical
negative predictive value (81.17% vs. 81.54%). Conclusion: Vaginal touch was also as relevant as transvaginal ultrasound while
evaluating the risk of preterm delivery. For the lack of ultrasound in
emergency rooms, a good physical examination would be sufficient by its own to
decide of an adequate management when there is a threat of preterm delivery.