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.
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

To establish reference values for the cervical length (CL) measurement by transvaginal ultrasound between 20 and 24+6 weeks of gestation in a large Brazilian population. A retrospective cross-sectional study was performed with 996 singleton pregnancies. The CL measurement (mm) using the transvaginal ultrasound 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. The median±standard deviation and ranges for the CL measurement (mm) was 37.0±10.7 (range, 8 to 51). CL measurement did not modify significantly with gestational age. The observed percentiles for the CL measurement (mm) considering all number case were the following: 5th, 28 mm; 50th, 37 mm; and 95th, 45 mm. Reference values for the CL measurement by transvaginal ultrasound between 20 and 24+6 weeks of gestation in a large heterogeneous Brazilian population were established.
Cervical Length Measurement* ; Cervix Uteri ; Cross-Sectional Studies ; Female ; Gestational Age ; Humans ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Reference Values* ; Retrospective Studies ; Ultrasonography*

PURPOSE: The aim of this study was to evaluate whether the presence of an intrauterine hematoma (IUH) on an early pregnancy ultrasound scan showing a live fetus was related to adverse perinatal outcomes. METHODS: We performed a retrospective cohort study to evaluate pregnant women who underwent an ultrasound examination in early pregnancy, between 6 weeks 0 days and 10 weeks 6 days. We compared the perinatal outcomes between women with and without firsttrimester IUH using the Mann-Whitney and Fisher exact tests. Furthermore, we performed a stepwise regression analysis to identify possible predictors of miscarriage among maternal characteristics, ultrasound parameters, and IUH. RESULTS: During the study period, data from 783 pregnancies were included, and the incidence of IUH was 4.5% (35 of 783). We observed a higher proportion of miscarriage following the scan (28.6% vs. 10%, P=0.003) and a larger yolk sac diameter during the scan (4.8 mm vs. 3.8 mm, P < 0.001) in the pregnant women with first-trimester IUH. There was no significant difference regard the prevalence of low birth weight (LBW; P=0.091), very LBW (P=0.370), or extremely LBW (P=0.600) between cases with IUH and without IUH, the cesarean section rate (68% vs. 81%, P=0.130), preterm delivery (16% vs. 16%, P>0.999), or the incidence of first-trimester vaginal bleeding (31% vs. 20%, P=0.130). Moreover, heart rate (HR) was the only variable that predicted miscarriage with statistical significance (P=0.017). CONCLUSION: Women with first-trimester IUH had a higher risk of miscarriage after the ultrasound scan. HR was the only variable that predicted miscarriage with statistical significance.
Abortion, Spontaneous ; Cesarean Section ; Cohort Studies ; Female ; Fetus ; Heart Rate ; Hematoma* ; Humans ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Pregnancy ; Pregnancy Complications ; Pregnancy Trimester, First ; Pregnant Women ; Prevalence ; Retrospective Studies ; Ultrasonography ; Uterine Hemorrhage ; Yolk Sac