Second trimester cervical length measurement for prediction spontaneous preterm birth in an unselected risk population.
10.5468/ogs.2017.60.4.329
- Author:
Alberto Borges PEIXOTO
1
;
Taciana Mara Rodrigues DA CUNHA CALDAS
;
Luisa Almeida TAHAN
;
Caetano Galvão PETRINI
;
Wellington P MARTINS
;
Fabricio Da Silva COSTA
;
Edward ARAUJO JÚNIOR
Author Information
1. Mario Palmério University Hospital, University of Uberaba (UNIUBE), Uberaba-MG, Brazil.
- Publication Type:Original Article
- Keywords:
Cervix uteri;
Pregnancy trimester, second;
Preterm birth;
Screening;
Transvaginal ultrasound
- MeSH:
Cervical Length Measurement*;
Cervix Uteri;
Cohort Studies;
Female;
Gestational Age;
Humans;
Linear Models;
Mass Screening;
Pregnancy;
Pregnancy Trimester, Second*;
Pregnant Women;
Premature Birth*;
Progesterone;
Retrospective Studies;
ROC Curve;
Term Birth;
Ultrasonography
- From:Obstetrics & Gynecology Science
2017;60(4):329-335
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To assess the predictive capacity of cervical length (CL) measurement underwent during the second trimester ultrasound for prediction preterm birth <32, 34, and 37 weeks of gestation in an unselected risk population. METHODS: A retrospective cohort study was performed with 751 singleton pregnancies between 20 and 24+6 weeks of gestation. The CL measurement (mm) using the transvaginal route was obtained in a sagittal view and the calipers positioned to measure the linear distance between the triangular area of echodensity at the external os and the internal os. To compare the preterm (<37 weeks) and term births (≥37 weeks), we used unpaired t test. We assessed whether the CL measurement was dependent of gestational age by performing a linear regression and assessing the coefficient of determination (R²). We additionally assessed the accuracy of CL measurement to predict preterm birth by assessing the area under receiver operating characteristics curves with its respective confidence intervals (CIs) 95%. RESULTS: Preterm birth <37 weeks was found in 13.6% (102/751) of pregnant women. Short cervix (≤25 mm) was found in 2.7% (20/751) of pregnancies. Only 30% (6/20) of pregnant women with short cervix have used progesterone to prevent preterm birth. There was a weak correlation between CL measurement and gestational age at delivery (R²=0.01, P=0.002). Receiver operating characteristics curve analysis of the ability of CL measurement to predict preterm birth <32, 34, and 37 weeks, showed an area under the curve of 0.693 (95% CI, 0.512 to 0.874), 0.472 (95% CI, 0.353 to 0.591), 0.490 (95% CI, 0.426 to 0.555), respectively. CONCLUSION: There was a weak correlation between CL measurement and gestational age at delivery. In an unselected population, CL measurement screening at 20 to 24+6 weeks of gestation does not seem to be a good predictor of preterm birth.
