DIAGNOSTIC ACCURACY OF TRANSABDOMINAL SONOGRAPHY IN DIAGNOSING SHORT CERVICAL LENGTH KEEPING TRANSVAGINAL SONOGRAPHY AS THE GOLD STANDARD

Background: Transvaginal ultrasound is a gold standard technique for diagnosing short cervix. This study aimed to determine the diagnostic accuracy of transabdominal sonography (TAS) in diagnosing short cervical length in 20–28 week pregnant women keeping transvaginal ultrasound as the gold standard. Methods: It was a cross-sectional study, conducted in the Department of Radiology, DHQ Hospital, Narowal from 1st July 2023 to 1st March 2024. A total of 321, 20–28 week pregnant women were included. Cervical length was measured initially by transabdominal ultrasound followed by transvaginal ultrasound. Results: Of the total 321 patients, 264 were true negative, 28 were false negative, 14 were false positive and 15 were true positive. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of TAS in assessing accurate cervical length are 34.8%, 94.8%, 51.7%, 90.4%, and 86.9% respectively. In all cases with transabdominal cervical length >35 mm, the NPV of transabdominal ultrasound reached 100%. Conclusion: TAS exhibits limited accuracy in correctly identifying short cervical length in women who indeed have a short cervical length. However, it demonstrates a strong ability to exclude short cervical length in women with a normal cervical length. Cervical length measured via transabdominal ultrasound can be reliably reported as safe if it exceeds 35 mm. For measurements below it, further evaluation with transvaginal ultrasound is recommended. Pak J Physiol 2024;20(3):49–52, DOI: https://doi.org/10.69656/pjp.v20i3.1651