Document Detail


Sonographic measurement of cervical length in twin pregnancies in threatened preterm labor.
MedLine Citation:
PMID:  14970998     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether sonographic measurement of cervical length in twin pregnancies presenting with threatened preterm labor helps distinguish between true and false labor. METHODS: In 87 women with twin pregnancies presenting with regular and painful uterine contractions at 24-36 (median, 30) weeks of gestation, cervical length was measured by transvaginal ultrasound. Women presenting in active labor, defined by the presence of cervical dilation of 3 cm or more, with ruptured membranes and those who underwent a prior or subsequent cervical cerclage, were excluded from the study. The clinical management was determined by the attending obstetrician without taking into account the cervical length. Primary outcome of the study was delivery within 7 days of presentation. RESULTS: Delivery within 7 days of presentation occurred in 19/87 (22%) pregnancies and this was inversely related to cervical length, decreasing from 80% (4/5) at 1-5 mm, to 46% (6/13) at 6-10 mm, 29% (4/14) at 11-15 mm, 21% (4/19) at 16-20 mm, 7% (1/15) at 21-25 mm and 0% (0/21) at >25 mm. Logistic regression analysis demonstrated that significant independent contribution in the prediction of delivery within 7 days was provided by cervical length (odds ratio (OR) = 0.78, 95% CI 0.68-0.89, P < 0.001) and use of tocolytics (OR = 0.13, 95% CI 0.02-0.76, P = 0.024), with no significant contribution from gestation at presentation, chorionicity, ethnic origin, maternal age, body mass index, parity, previous history of preterm delivery, cigarette smoking, contraction frequency, vaginal bleeding or the administration of antibiotics or steroids. CONCLUSION: In women with twin pregnancies presenting with threatened preterm labor, sonographic measurement of cervical length helps distinguish between those who deliver within 7 days and those who do not.
Authors:
I Fuchs; E Tsoi; W Henrich; J W Dudenhausen; K H Nicolaides
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  23     ISSN:  0960-7692     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-02-18     Completed Date:  2004-05-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  42-5     Citation Subset:  IM    
Copyright Information:
Copyright 2004 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Virchow Clinic Charité, Berlin, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Body Mass Index
Cervix Uteri / anatomy & histology,  ultrasonography*
Female
Humans
Maternal Age
Obstetric Labor, Premature / ultrasonography*
Pain / etiology
Parity
Pregnancy
Pregnancy, Multiple*
Prospective Studies
Regression Analysis
Twins
Ultrasonography, Prenatal / methods*
Uterine Contraction

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


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