The Efficacy and Efficiency of Uterocervical Angle Measurements to Predict Preterm Labor in Idiopathic Polyhydramnios Patients: A Prospective Cohort Study.

INTRODUCTION Uterocervical angle measurements in pregnant women with idiopathic polyhydramnios were appraised for their predictive value for spontaneous preterm labor. MATERIAL AND METHODS In this prospective study, we included nulliparous and multiparous pregnant women diagnosed with idiopathic polyhydramnios at 24-28 weeks at our polyclinic; the uterocervical angle and cervical length were measured by transvaginal ultrasound at the time of diagnosis. Routine pregnancy follow-up was done by our team and gestational age at delivery and maternal-fetal outcomes were noted. RESULTS In total, 24 patients delivered before 37 weeks and 36 patients delivered at 37 weeks or later. Preterm labor subjects had larger UCA values (126.7±12.9° vs. 100.8±16.2°) and term labor patients had larger cervical length values (34.3±4.5 mm vs. 40.6±5.2 mm). In women with idiopathic polyhydramnios, the area under the curve for the uterocervical angle was 0.885 (p<0.001) and it was 0.823 for the cervical length (p<0.001). DISCUSSION The uterocervical angle, a sagittal transvaginal cervical image measurement, is a practical method that successfully predicts spontaneous preterm labor risk in singleton pregnancies with idiopathic polyhydramnios. In addition, the uterocervical angle displayed greater sensitivity, but lower specificity, compared with cervical length measures.