| Predicting preterm delivery in asymptomatic patients with prior preterm delivery by measurement of cervical length and phosphorylated insulin-like growth factor-binding protein-1. | |
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MedLine Citation:
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PMID: 17444550 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the efficacy of cervical length measurement in combination with a bedside assessment of phosphorylated insulin-like growth factor-binding protein-1 (phIGFBP-1) as a predictor of preterm delivery in asymptomatic pregnant women with a history of preterm birth. METHODS: Cervical length was measured using transvaginal sonography at 22-24 weeks of gestation in 105 singleton pregnancies and a rapid strip test was performed to detect phIGFBP-1 in cervical secretions from 24 to 34 weeks. Receiver-operating characteristics (ROC) curves were constructed to compare the performance of phIGFBP-1 at different gestational ages, and cervical length at 22-24 weeks, in predicting preterm delivery. RESULTS: The rate of spontaneous delivery before 37 and 34 weeks was 23.8% and 11.4%, respectively. Women with cervical lengths less than 20 mm had a risk of spontaneous preterm delivery before 34 and 37 weeks of 43.5% and 69.6%, respectively. The performance of phIGFBP-1 levels as a predictor of preterm delivery was significantly higher when the test was carried out at 30 weeks' gestation. Cervical assessment in combination with phIGFBP-1 at 30 weeks had the steepest ROC curve (area under the curve=0.93; 95% CI, 0.88-0.98, P<0.001). CONCLUSION: Both cervical length and phIGFBP-1 measurement are useful in the prediction of preterm delivery in patients with a history of preterm birth and the combined method of measuring cervical length at 22-24 weeks and phIGFBP-1 at 30 weeks improves upon either method used alone. |
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Authors:
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R E Bittar; E B da Fonseca; M H B de Carvalho; S Martinelli; M Zugaib |
Publication Detail:
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Type: Evaluation Studies; 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: 29 ISSN: 0960-7692 ISO Abbreviation: Ultrasound Obstet Gynecol Publication Date: 2007 May |
Date Detail:
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Created Date: 2007-04-26 Completed Date: 2008-02-19 Revised Date: - |
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: 562-7 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2007 ISUOG. |
Affiliation:
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Obstetric Clinic, University of São Paulo Medical School, São Paulo, Brazil. rebittar@usp.br |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Biological Markers / analysis, metabolism Birth Weight Cervix Uteri / anatomy & histology, metabolism, ultrasonography* Female Gestational Age Gravidity Humans Insulin-Like Growth Factor Binding Protein 1 / analysis* Phosphorylation Predictive Value of Tests Pregnancy Pregnancy Outcome Pregnancy Trimester, Second Pregnancy Trimester, Third Premature Birth / diagnosis*, metabolism, ultrasonography ROC Curve Risk Assessment / methods |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/IGFBP1 protein, human; 0/Insulin-Like Growth Factor Binding Protein 1 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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