Document Detail

Two-stage transvaginal cervical length screening for preterm birth in twin pregnancies.
MedLine Citation:
PMID:  20629488     Owner:  NLM     Status:  MEDLINE    
AIM: To compare cervical length (CL) at 18-21 and 22-25 weeks' gestation in twin pregnancies in prediction of spontaneous preterm delivery and to examine cervical shortening.
METHODS: Retrospective cohort study of CL measured at 18-21 and 22-25 weeks' gestation in twin pregnancies.
RESULTS: Receiver operating characteristics (ROC) curve revealed area of 0.64 (95% CI 0.53-0.75) and 0.80 (95% CI 0.72-0.88) for measurements at 18-21 and 22-25 weeks, respectively (P<or=0.001). Sensitivities of 33.3% and 23% and negative predicting value (NPV) of 97.3% and 86.8% for delivery at <28 and <34 weeks gestation were reached for measurements at 18-21 weeks. Sensitivities of 71.4% and 38.2% and NPV of 99.1% and 91.4% for delivery at <28 and <34 weeks' gestation were reached for measurements at 22-25 weeks. Cervical length shortening analysis showed an area under ROC curve of 0.81 (95% CI 0.73-0.89) and best cut-off was at >or=2 mm/week. Sensitivities of 80% and 60.8% and NPV of 98.9% and 90.6% for delivery at <28 and <34 weeks gestation were reached.
CONCLUSIONS: In twin gestations, assessment of CL at 22-25 weeks is better than assessment at 18-21 weeks to predict preterm delivery before 34 weeks. Cervical shortening at a rate of >or=2 mm/weeks between 18 and 25 weeks gestation was a good predictor of spontaneous preterm birth in this high-risk population.
Carolina Hofmeister; Maria de Lourdes Brizot; Adolfo Liao; Rossana P V Francisco; Marcelo Zugaib
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Publication Detail:
Type:  Journal Article; Twin Study    
Journal Detail:
Title:  Journal of perinatal medicine     Volume:  38     ISSN:  1619-3997     ISO Abbreviation:  J Perinat Med     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-03     Completed Date:  2011-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0361031     Medline TA:  J Perinat Med     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  479-84     Citation Subset:  IM    
Department of Obstetrics, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil.
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MeSH Terms
Cervical Length Measurement* / statistics & numerical data
Cervix Uteri / ultrasonography
Cohort Studies
Gestational Age
Infant, Newborn
Predictive Value of Tests
Pregnancy Trimester, Second
Pregnancy, Multiple*
Premature Birth / etiology,  ultrasonography*
Retrospective Studies
Risk Factors

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