Document Detail


Predicting preterm delivery in asymptomatic patients with prior preterm delivery by measurement of cervical length and phosphorylated insulin-like growth factor-binding protein-1.
MedLine Citation:
PMID:  17444550     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
R E Bittar; E B da Fonseca; M H B de Carvalho; S Martinelli; M Zugaib
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
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:
Created Date:  2007-04-26     Completed Date:  2008-02-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  562-7     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2007 ISUOG.
Affiliation:
Obstetric Clinic, University of São Paulo Medical School, São Paulo, Brazil. rebittar@usp.br
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MeSH Terms
Descriptor/Qualifier:
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:
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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