Universal transvaginal ultrasound found cost-effective

(HealthDay)—Under most assumptions, universal transvaginal ultrasound (TVUS) is more cost-effective than an initial transabdominal ultrasound (TAUS) screening for measuring cervical length and identifying women at increased risk of preterm birth, according to research published in the December issue of the American Journal of Obstetrics & Gynecology.

Emily S. Miller, M.D., M.P.H., and William A. Grobman, M.D., M.B.A., of the Feinberg School of Medicine at Northwestern University in Chicago, applied a decision analytic model to a hypothetical cohort of women with singleton pregnancies to compare initial TAUS with universal TVUS as screening for short cervical length, which is associated with increased risk of preterm birth.

The researchers found that, compared with TAUS, universal TVUS as screening to measure cervical length reduced the rate of preterm birth by 0.03 percent, reduced costs by $1.2 million, and increased quality-adjusted life years by 70 per 100,000 women. Variables that affected the results of this model included the cost of the TVUS, the prevalence of a short cervix in the population screened, and the test characteristics (i.e., sensitivity and specificity) of a TAUS screening for short cervical length.

"In summary, when compared with an initial TAUS screening strategy for short cervical length, universal TVUS was a more cost-effective strategy under most assumptions," the authors write.

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