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The change in cervical length over time as a predictor of preterm delivery in asymptomatic women with twin pregnancies who have a normal mid-trimester cervical length.
MedLine Citation:
PMID:  22854157     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Aim: To determine whether or not the change in cervical length (CL) over time is valuable in predicting spontaneous preterm delivery (SPTD) in asymptomatic twin pregnancies with a normal mid-trimester CL (>25 mm). Methods: This was a prospective study including 190 consecutive asymptomatic twin gestations with a CL > 25 mm at 20-24 weeks. The women underwent an initial CL measurement at the time of routine ultrasound examination between 20 and 24 weeks' gestation, followed 4-5 weeks later by a repeat CL measurement. The primary outcome measure was SPTD at <32 completed weeks' gestation. Multicollinearity was a concern in the multivariable model since change in CL and follow-up CL were highly correlated. Results: The rate of SPTD at <32 weeks was 4.2%. Multiple logistic regression analyses demonstrated that the change in CL and the follow-up CL were significantly associated with SPTD before 32 weeks after adjusting for baseline covariate such as in vitro fertilization. The best cut-off values for the prediction of SPTD at <32 weeks' gestation were 13% for the change in CL with a sensitivity of 87.5% and a specificity of 63.2%. There was no significant difference in the area under the receiver operating characteristic curves between the change in CL and the follow-up CL. Conclusions: A greater change in CL is a good predictor of SPTD in asymptomatic twin pregnancies with a normal mid-trimester CL. However, the change in CL cannot provide data beyond the follow-up CL. In the setting of a normal mid-trimester CL, a follow-up CL measurement should be considered in asymptomatic twin pregnancies.
Authors:
Kyung Joon Oh; Kyo Hoon Park; Eun Ha Jeong; Sung Youn Lee; Aeli Ryu; Shi-Nae Kim
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Twin research and human genetics : the official journal of the International Society for Twin Studies     Volume:  15     ISSN:  1832-4274     ISO Abbreviation:  Twin Res Hum Genet     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-08-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101244624     Medline TA:  Twin Res Hum Genet     Country:  England    
Other Details:
Languages:  eng     Pagination:  516-21     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Korea.
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