Reliability of ultrasound versus digital vaginal examination in detecting cervical dilatation during labor: a diagnostic test accuracy systematic review

Abstract

Background: This systematic review aimed to investigate the reliability of ultrasound method compared with digital vaginal examinations in detecting cervical dilation. Methods: We searched Cochrane (CENTRAL), MEDLINE, EMBASE, CINAHL, ISI Web of Science Core Collection, Trip Database, PubMed, DARE and NHS EED, HTA, and PROSPERO. Ten observational studies with a total sample size of 856 were included in the meta-analysis. Results: The intraclass correlation coefficient (ICC) values ranged between 0.21 and 0.69. The fixed-effect models for the ultrasound test showed an average of ICC (r = 0.32 (95% CI 0.26–0.38). Correlation between two methods was poor (r = 0.359, 95% CI 0.26–0.44). In nulliparous and multigravida participants the correlation between ultrasound measurements and digital examinations was (r = 0.349, 95% CI 0.25–0.43) and ICC (r = 0.676, 95% CI 0.419–0.833), respectively. Conclusion: Trans-perineal ultrasonography seems to be a reliable method for assessing labor progression in multigravida women, but its usage in nulliparous women needs further studies.