Two-stage transvaginal cervical length screening for preterm birth in twin pregnancies
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Carolina Hofmeister
Abstract
Aim: To compare cervical length (CL) at 18–21 and 22–25 weeks' gestation in twin pregnancies in prediction of spontaneous preterm delivery and to examine cervical shortening.
Methods: Retrospective cohort study of CL measured at 18–21 and 22–25 weeks' gestation in twin pregnancies.
Results: Receiver operating characteristics (ROC) curve revealed area of 0.64 (95% CI 0.53–0.75) and 0.80 (95% CI 0.72–0.88) for measurements at 18–21 and 22–25 weeks, respectively (P≤0.001). Sensitivities of 33.3% and 23% and negative predicting value (NPV) of 97.3% and 86.8% for delivery at <28 and <34 weeks gestation were reached for measurements at 18–21 weeks. Sensitivities of 71.4% and 38.2% and NPV of 99.1% and 91.4% for delivery at <28 and <34 weeks' gestation were reached for measurements at 22–25 weeks. Cervical length shortening analysis showed an area under ROC curve of 0.81 (95% CI 0.73–0.89) and best cut-off was at ≥2 mm/week. Sensitivities of 80% and 60.8% and NPV of 98.9% and 90.6% for delivery at <28 and <34 weeks gestation were reached.
Conclusions: In twin gestations, assessment of CL at 22–25 weeks is better than assessment at 18–21 weeks to predict preterm delivery before 34 weeks. Cervical shortening at a rate of ≥2 mm/weeks between 18 and 25 weeks gestation was a good predictor of spontaneous preterm birth in this high-risk population.
©2010 by Walter de Gruyter Berlin New York
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Artikel in diesem Heft
- Review article
- Monochorionic twin pregnancy: screening, pathogenesis of complications and management in the era of microinvasive fetal surgery
- Original articles – Obstetrics
- Longitudinal examination of cervical volume and vascularization changes during the antepartum and postpartum period using three-dimensional and power Doppler ultrasound
- Uterine and umbilical artery Doppler velocimetry as a predictor for adverse pregnancy outcomes in pregnant women with anemia
- Prooxidant-antioxidant balance in pregnancy: a randomized double-blind placebo-controlled trial of selenium supplementation
- Two-stage transvaginal cervical length screening for preterm birth in twin pregnancies
- The relationship between placental histology and cervical length in twin gestations
- A novel method for evaluating uterine cervical consistency using vaginal ultrasound gray-level histogram
- Microbial invasion of the amniotic cavity in pregnancies with small-for-gestational-age fetuses
- Microbial invasion of the amniotic cavity in preeclampsia as assessed by cultivation and sequence-based methods
- Original articles – Fetus
- Perinatal exposure to di-(2-ethylhexyl) phthalate leads to restricted growth and delayed lung maturation in newborn rats
- Calprotectin in human cord blood: relation to perinatal parameters and restricted fetal growth
- Original articles – Newborn
- Diagnostic value of interleukin-6 and C-reactive protein on early onset bacterial infection in preterm neonates with respiratory distress
- Simulated transport alters surfactant homeostasis and causes dose-dependent changes in respiratory function in neonatal Sprague-Dawley rats
- Early protective effect of hypothermia in newborn pigs after hyperoxic, but not after normoxic, reoxygenation
- Surfactant administration for neonatal respiratory distress does not improve lung interstitial fluid clearance: echographic and experimental evidence
- Letter to the editor
- Double aneuploidy of trisomy 18 and Klinefelter syndrome: prenatal diagnosis and perinatal outcome
- Congress Calender
- Congress Calendar
