Document Detail


Second-trimester cervical sonography: features other than cervical length to predict spontaneous preterm birth.
MedLine Citation:
PMID:  14990406     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To estimate whether cervical and lower uterine segment characteristics other than cervical length and funneling predict recurrent preterm birth. METHODS: We conducted a secondary analysis of a multicenter, blinded observational study of 181 women with singletons and prior spontaneous preterm births. Endovaginal ultrasonic examinations were performed at 2-week intervals between 16 0/7 weeks and 23 6/7 weeks of gestation. Cervical canal contour (straight/curved), cervical position (horizontal/vertical), posterior cervical width, lower uterine segment thickness, vascularity, endocervical canal dilation, with or without associated membrane prolapse and chorioamnion visible at the internal os, were systematically assessed. RESULTS: At the initial sonogram (16 0/7-18 6/7 weeks), membranes visible overlying the internal os (relative risk 1.9, confidence interval [CI] 1.2, 3.1) and canal dilation of 2-4 mm (relative risk 2.6, CI 1.4, 4.7) were significant predictors of spontaneous preterm birth of less than 35 weeks in univariate analyses. Only canal dilation remained statistically significant after controlling for cervical length (odds ratio 5.5, CI 1.1, 28.6). CONCLUSION: Endocervical canal dilation of 2-4 mm during second-trimester endovaginal sonography was associated with an increased risk of recurrent preterm delivery independent of cervical length. LEVEL OF EVIDENCE: II-2
Authors:
Nicole P Yost; John Owen; Vincenzo Berghella; Cora MacPherson; Melissa Swain; Gary A Dildy; Menachem Miodovnik; Oded Langer; Baha Sibai;
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  103     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-03-01     Completed Date:  2004-04-08     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  457-62     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9032, USA. Nicole.Yost@utsouthwestern.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Cervix Uteri / ultrasonography*
Female
Humans
Labor Stage, First
Obstetric Labor, Premature / etiology*
Predictive Value of Tests
Pregnancy
Pregnancy Trimester, Second
Recurrence
Retrospective Studies
Risk Factors
Ultrasonography, Prenatal*
Grant Support
ID/Acronym/Agency:
HD 19897/HD/NICHD NIH HHS; HD 21414/HD/NICHD NIH HHS; HD 27860/HD/NICHD NIH HHS; HD 27869/HD/NICHD NIH HHS; HD 27905/HD/NICHD NIH HHS; HD 34116/HD/NICHD NIH HHS; HD 34136/HD/NICHD NIH HHS; HD 34208/HD/NICHD NIH HHS; HD 34210/HD/NICHD NIH HHS; HD 36801/HD/NICHD NIH HHS

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


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