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Cervical length measurement for the prediction of preterm birth in multiple pregnancies: a systematic review and bivariate meta-analysis.
MedLine Citation:
PMID:  21465606     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: To review the literature on cervical length as a predictor of preterm birth in asymptomatic women with a multiple pregnancy. METHODS: We searched Medline, Embase and reference lists of included articles to identify all studies that reported on the accuracy of cervical length to predict preterm birth in asymptomatic women with a multiple pregnancy. We scored study characteristics and study quality, and extracted data in order to construct two-by-two tables cross classifying cervical length and preterm delivery. Meta-analysis using a bivariate model was performed. Summary receiver operating characteristics were generated for various test characteristics and outcome definitions. RESULTS: We detected 21 studies, reporting on 2,757 women. There was a large variation in gestational age at measurement, cut-off points for cervical length and definitions of preterm birth. The summary ROC-curve indicated a good predictive capacity of short cervical length for preterm birth. Summary estimates of sensitivity and specificity for preterm birth before 34 weeks were 78% and 66% respectively for 35 mm, 41% and 87% for 30 mm, 36% and 94% for 25 mm and 30% and 94% for 20 mm. CONCLUSIONS: In women with a multiple pregnancy, second trimester cervical length is a strong predictor of preterm birth. In the absence of effective preventive strategies, there is currently no place in clinical practice for cervical length measurement in this population. However, future studies should evaluate preventive interventions in women with multiple pregnancies and a short cervix, and cervical length should be measured in any trial that studies preventive strategies in multiple pregnancies. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
A C Lim; M A Hegeman; M A Huis In 't Veld; B C Opmeer; H W Bruinse; B W J Mol
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-4
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Department of Obstetrics and Gynaecology, Academic Medical Centre Amsterdam, The Netherlands. A.C.Lim@amc.nl.
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