| Does transvaginal sonographic measurement of cervical length before 14 weeks predict preterm delivery in high-risk pregnancies? | |
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MedLine Citation:
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PMID: 12601834 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine whether high-risk patients manifest cervical length < 25 mm on transvaginal ultrasound before 14 weeks of gestation, and if this finding is predictive of preterm delivery. METHODS: Asymptomatic pregnancies at high risk for preterm birth were followed prospectively from 10 + 0 weeks to 13 + 6 weeks with transvaginal sonographic measurement of the cervix. A cervical length < 25 mm was considered a short cervix at this gestational age and at the follow-up ultrasound examinations, performed between 14 and 24 weeks. The primary outcome was preterm birth at < 35 weeks of gestation. RESULTS: One hundred and eighty-three pregnancies met the study criteria and were included in the analysis. Only 10 (5%) patients had a cervix < 25 mm before 14 weeks. The sensitivity, specificity and positive and negative predictive values of a short cervix were 14%, 97%, 50%, and 82%, respectively (relative risk, 2.8; 95% confidence interval, 1.4-5.6). The mean transvaginal sonographic cervical length before 14 weeks of gestation was 33.7 +/- 6.9 mm in pregnancies which delivered preterm (n = 36), and 35.0 +/- 6.8 mm in those delivering at term (n = 147) (P = 0.3). Follow-up transvaginal ultrasound examination of the cervix to 24 weeks revealed that the average gestational age at which a short cervix was detected was 18.7 +/- 2.9 weeks. CONCLUSION: A cervical length < 25 mm on transvaginal sonographic assessment rarely occurs before 14 weeks even in high-risk patients destined to deliver preterm; in these patients cervical changes predictive of preterm birth develop mostly after this gestational age. |
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Authors:
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V Berghella; M Talucci; A Desai |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology Volume: 21 ISSN: 0960-7692 ISO Abbreviation: Ultrasound Obstet Gynecol Publication Date: 2003 Feb |
Date Detail:
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Created Date: 2003-02-25 Completed Date: 2003-05-16 Revised Date: 2005-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9108340 Medline TA: Ultrasound Obstet Gynecol Country: England |
Other Details:
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Languages: eng Pagination: 140-4 Citation Subset: IM |
Copyright Information:
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Copyright 2003 ISUOG. Published by John Wiley & Sons, Ltd. |
Affiliation:
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Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, Jefferson Medical College of Thomas Jefferson University, Philadelphia 19107, USA. vincenzo.berghella@mail.tju.edu |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cervix Uteri / anatomy & histology, ultrasonography* Female Follow-Up Studies Humans Obstetric Labor, Premature / ultrasonography* Predictive Value of Tests Pregnancy Pregnancy Trimester, First Pregnancy, High-Risk* Prospective Studies Sensitivity and Specificity |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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