Document Detail


Gestational age at cervical length measurement and incidence of preterm birth.
MedLine Citation:
PMID:  17666605     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To estimate the risk of spontaneous preterm birth based on transvaginal ultrasound cervical length and gestational age at which cervical length was measured. METHODS: Women at high risk for spontaneous preterm birth and with transvaginal ultrasound cervical length measurements between weeks 12 and 32 were identified at one institution between July 1995 and June 2005. Inclusion criteria for women at high risk for spontaneous preterm birth were prior spontaneous preterm birth at 14 to 35 weeks, cone biopsy, müllerian anomaly, or two or more dilation and evacuations. Women with multiple gestations, cerclage, indicated preterm birth, or fetal anomalies were excluded. Logistic regression was used to estimate the spontaneous preterm birth risk before 35, 32, and 28 weeks. RESULTS: Seven hundred five women received 2,601 transvaginal ultrasound measurements for cervical length. The incidences of spontaneous preterm birth before 35, 32, and 28 weeks were 17.7, 10.6, and 6.7%, respectively. The risk of spontaneous preterm birth before 35 weeks decreased by approximately 6% for each additional millimeter of cervical length (odds ratio 0.94, 95% confidence interval, 0.92-0.95, P=.001) and by approximately 5% for each additional week of pregnancy at which the cervical length was measured (odds ratio 0.95, 95% confidence interval 0.92-0.98, P=.004). Similar results were obtained for spontaneous preterm birth before 32 and 28 weeks. CONCLUSION: Gestational age at which transvaginal ultrasound cervical length is measured significantly affects the calculation of risk of spontaneous preterm birth. The spontaneous preterm birth risk increases as the length of the cervix declines and as the gestational age decreases. These spontaneous preterm birth risks are important for counseling and management for women with various degrees of short cervical length at different gestational ages. LEVEL OF EVIDENCE: II.
Authors:
Vincenzo Berghella; Amanda Roman; Constantine Daskalakis; Amen Ness; Jason K Baxter
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  110     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-01     Completed Date:  2007-08-30     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  311-7     Citation Subset:  AIM; IM    
Affiliation:
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Jefferson Medical College, Thomas Jefferson University, 834 Chestnut Street, Philadelphia, PA 19107, USA. vincenzo.berghella@jefferson.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Anthropometry / methods
Cervix Uteri / anatomy & histology*,  ultrasonography
Female
Gestational Age
Humans
Predictive Value of Tests
Pregnancy
Pregnancy Outcome
Pregnancy Trimesters / physiology
Pregnancy, High-Risk
Premature Birth / diagnosis*
Prospective Studies
Retrospective Studies
Ultrasonography, Prenatal / methods*
Comments/Corrections
Comment In:
Obstet Gynecol. 2007 Dec;110(6):1427; author reply 1427   [PMID:  18055747 ]

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


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