Document Detail


Cervical length as a predictor of pre-term birth in twin gestations.
MedLine Citation:
PMID:  11463141     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to determine the predictive value of cervical length as a risk factor for spontaneous pre-term birth in twin gestations. A retrospective chart review was carried out on patients with twin pregnancies referred to our multiples' clinic. Cervical length was measured by transvaginal ultrasonography. Patients with an indicated pre-term delivery or intervention were excluded from the analysis. Outcomes included preterm delivery < 28 and < 35 weeks gestation. After extracting the data, 2 x 4 tables were constructed. Likelihood ratios were then generated for cervical lengths < or = 2.0 cm, < or = 2.5 cm, < or = 3.0 cm, and > 3.0 cm. Because of the limited number of measurements taken < 25 weeks gestation, we elected to collapse the tables, thereby achieving more meaningful results. For measurements taken before 30 weeks gestation, a shorter cervix did predict delivery < 28 weeks gestation (likelihood ratios for cervical lengths < or = 2.0 cm, < or = 2.5 cm, < or = 3.0 cm, and > 3.0 cm were 4.43, 1.94, 0.97, and 1.02, respectively). The probability of preterm delivery < 35 weeks gestation increased with decreasing cervical length (likelihood ratios for cervical length < or = 2.0 cm, < or = 2.5 cm, < or = 3.0 cm, and > 3.0 cm were 2.58, 1.66, 1.38, and 0.81, respectively). A shorter cervix measured before 30 weeks gestation was a stronger predictor of preterm delivery < 28 weeks compared to < 35 weeks gestation. Cervical length was not predictive of preterm delivery if measured after 30 weeks. Cervical length is predictive of preterm delivery < 28 weeks and < 35 weeks gestation when measured before 30 weeks gestation. No trend was seen when measured after 30 weeks gestation. A prospective study is currently underway to confirm these results.
Authors:
J L Shapiro; R Kung; J F Barrett
Publication Detail:
Type:  Journal Article; Validation Studies    
Journal Detail:
Title:  Twin research : the official journal of the International Society for Twin Studies     Volume:  3     ISSN:  1369-0523     ISO Abbreviation:  Twin Res     Publication Date:  2000 Dec 
Date Detail:
Created Date:  2001-07-20     Completed Date:  2001-08-09     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  9815819     Medline TA:  Twin Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  213-6     Citation Subset:  IM    
Affiliation:
Deportment of Obstetrics and Gynecology, Sunnybrook and Women's College Health Sciences Center, University of Toronto, Ontario, Canada. jodi.shapiro@utoronto.ca
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MeSH Terms
Descriptor/Qualifier:
Anthropometry / methods*
Cervix Uteri / ultrasonography*
Female
Gestational Age
Humans
Likelihood Functions
Obstetric Labor, Premature / etiology,  ultrasonography*
Predictive Value of Tests
Pregnancy
Retrospective Studies
Risk Factors
Time Factors
Twins*
Ultrasonography, Prenatal / methods*,  standards*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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