scholarly journals EP01.03: Mid‐trimester cervical consistency index and cervical length to predict spontaneous preterm birth in twins

2019 ◽  
Vol 54 (S1) ◽  
pp. 224-225
Author(s):  
J. Merwe ◽  
L. Lewi ◽  
N. Baños ◽  
M. Palacio ◽  
J. Deprest
Keyword(s):  
Preterm Birth ◽  
Cervical Length ◽  
Consistency Index ◽  
Spontaneous Preterm Birth

scholarly journals The Predictive Value of the Cervical Consistency Index to Predict Spontaneous Preterm Birth in Asymptomatic Twin Pregnancies at the Second-Trimester Ultrasound Scan: A Prospective Cohort Study

2020 ◽  
Vol 9 (6) ◽  
pp. 1784
Author(s):  
Johannes van der Merwe ◽  
Isabel Couck ◽  
Francesca Russo ◽  
Xavier P. Burgos-Artizzu ◽  
Jan Deprest ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Birth ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Transvaginal Ultrasound ◽  
Characteristic Curve ◽  
Cervical Length ◽  
Consistency Index ◽  
Spontaneous Preterm Birth ◽  
Twin Pregnancies

Novel transvaginal ultrasound (TVU) markers have been proposed to improve spontaneous preterm birth (sPTB) prediction. Preliminary results of the cervical consistency index (CCI), uterocervical angle (UCA), and cervical texture (CTx) have been promising in singletons. However, in twin pregnancies, the results have been inconsistent. In this prospective cohort study of asymptomatic twin pregnancies assessed between 18+0–22+0 weeks, we evaluated TVU derived cervical length (CL), CCI, UCA, and the CTx to predict sPTB < 34+0 weeks. All iatrogenic PTB were excluded. In the final cohort of 63 pregnancies, the sPTB rate < 34+0 was 16.3%. The CCI, UCA, and CTx, including the CL was significantly different in the sPTB < 34+0 weeks group. The best area under the receiver operating characteristic curve (AUC) for sPTB < 34+0 weeks was achieved by the CCI 0.82 (95%CI, 0.72–0.93), followed by the UCA with AUC 0.72 (95%CI, 0.57–0.87). A logistic regression model incorporating parity, chorionicity, CCI, and UCA resulted in an AUC of 0.91 with a sensitivity of 55.3% and specificity of 88.1% for predicting sPTB < 34+0. The CCI performed better than other TVU markers to predict sPTB < 34+0 in twin gestations, and the best diagnostic accuracy was achieved by a combination of parity, chorionicity, CCI, and UCA.

scholarly journals Mid-Trimester Cervical Consistency Index and Cervical Length to Predict Spontaneous Preterm Birth in a High-Risk Population

2018 ◽  
Vol 08 (01) ◽  
pp. e43-e50 ◽  
Author(s):  
Núria Baños ◽  
Carla Julià ◽  
Núria Lorente ◽  
Silvia Ferrero ◽  
Teresa Cobo ◽  
...  
Keyword(s):  
Preterm Birth ◽  
High Risk ◽  
Area Under The Curve ◽  
Cervical Length ◽  
Consistency Index ◽  
High Risk Population ◽  
Spontaneous Preterm Birth ◽  
Predictive Capacity ◽  
Increased Risk ◽  
Better Than

Background Short cervical length (CL) has not been shown to be adequate as a single predictor of spontaneous preterm birth (sPTB) in high-risk pregnancies. Objective The objective of this study was to evaluate the performance of the mid-trimester cervical consistency index (CCI) to predict sPTB in a cohort of high-risk pregnancies and to compare the results with those obtained with the CL. Study Design Prospective cohort study including high-risk singleton pregnancies between 19+0 and 24+6 weeks. The ratio between the anteroposterior diameter of the uterine cervix at maximum compression and at rest was calculated offline to obtain the CCI. Results Eighty-two high sPTB risk women were included. CCI (%) was significantly reduced in women who delivered <37+0 weeks compared with those who delivered at term, while CL was not. The area under the curve (AUC) of the CCI to predict sPTB <37+0 weeks was 0.73 (95% confidence interval [CI], 0.61–0.85), being 0.51 (95% CI, 0.35–0.67), p = 0.03 for CL. The AUC of the CCI to predict sPTB <34+0 weeks was 0.68 (95% CI, 0.54–0.82), being 0.49 (95% CI, 0.29–0.69), p = 0.06 for CL. Conclusion CCI performed better than sonographic CL to predict sPTB. Due to the limited predictive capacity of these two measurements, other tools are still needed to better identify women at increased risk.

scholarly journals Prediction of Spontaneous Preterm Birth in At-risk Women Using Thrombospondin 1 from Cervicovaginal Fluid: A Prospective Observational Study

2021 ◽  
Vol 81 (09) ◽  
pp. 1055-1064
Author(s):  
Johannes Stubert ◽  
Kathleen Gründler ◽  
Bernd Gerber ◽  
Dagmar-Ulrike Richter ◽  
Max Dieterich
Keyword(s):  
At Risk ◽  
Preterm Birth ◽  
Predictive Value ◽  
Transvaginal Ultrasound ◽  
Area Under The Curve ◽  
Cervical Length ◽  
Multiple Gestation ◽  
Spontaneous Preterm Birth ◽  
Thrombospondin 1 ◽  
Cervicovaginal Fluid

Abstract Introduction Thrombospondin 1, desmoplakin and stratifin are putative biomarkers for the prediction of preterm birth. This study aimed to validate the predictive capability of these biomarkers in patients at risk of preterm birth. Materials and Methods We included 109 women with symptoms of threatened spontaneous preterm birth between weeks 20 0/7 and 31 6/7 of gestation. Inclusion criteria were uterine contractions, cervical length of less than 25 mm, or a personal history of spontaneous preterm birth. Multiple gestations were also included. Samples of cervicovaginal fluid were taken before performing a digital examination and transvaginal ultrasound. Levels of cervicovaginal thrombospondin 1, desmoplakin and stratifin were quantified by enzyme-linked immunosorbent assays. The primary endpoint was spontaneous preterm birth before 34 + 0 weeks of gestation. Results Sixteen women (14.7%) delivered before 34 + 0 weeks. Median levels of thrombospondin 1 were higher in samples where birth occurred before 34 weeks vs. ≥ 34 weeks of gestation (4904 vs. 469 pg/mL, p < 0.001). Receiver operator characteristics analysis resulted in an area under the curve of 0.86 (p < 0.0001). At an optimal cut-off value of 2163 pg/mL, sensitivity, specificity, positive predictive value and negative predictive value were 0.94, 0.77, 0.42 and 0.99, respectively, with an adjusted odds ratio of 32.9 (95% CI: 3.1 – 345, p = 0.004). Multiple gestation, cervical length, and preterm labor had no impact on the results. Survival analysis revealed a predictive period of more than eight weeks. Levels of desmoplakin and stratifin did not differ between groups. Conclusion Thrombospondin 1 allowed long-term risk estimation of spontaneous preterm birth.

Prediction of spontaneous preterm birth in asymptomatic twin pregnancies with the use of combined fetal fibronectin and cervical length

2009 ◽  
Vol 201 (3) ◽  
pp. 313.e1-313.e5 ◽  
Author(s):  
Nathan S. Fox ◽  
Daniel H. Saltzman ◽  
Chad K. Klauser ◽  
Danielle Peress ◽  
Christina V. Gutierrez ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Cervical Length ◽  
Spontaneous Preterm Birth ◽  
Fetal Fibronectin ◽  
Twin Pregnancies

Midtrimester Cervical Length in Low-Risk Nulliparous Women for the Prediction of Spontaneous Preterm Birth: Should We Consider a New Definition of Short Cervix?

2021 ◽  
Author(s):  
Paul Guerby ◽  
Mario Girard ◽  
Geneviève Marcoux ◽  
Annie Beaudoin ◽  
Jean-Charles Pasquier ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Health Care Providers ◽  
Gestational Age ◽  
Roc Curve ◽  
Transvaginal Ultrasound ◽  
Cervical Length ◽  
Care Providers ◽  
Operating Characteristics ◽  
Spontaneous Preterm Birth ◽  
Nulliparous Women

Objective The study aimed to estimate the predictive value of midtrimester cervical length (CL) and the optimal cut-off of CL that should be applied with asymptomatic nulliparous women for the prediction of spontaneous preterm birth (sPTB). Study Design This is a prospective cohort study of asymptomatic nulliparous women with a singleton gestation. Participants underwent CL measurement by transvaginal ultrasound between 20 and 24 weeks of gestation. The participants and their health care providers remained blinded to the results of CL measurement. The primary outcomes were sPTB before 35 weeks and sPTB before 37 weeks. Receiver operating characteristics (ROC) curve analyses were performed. Analyses were repeated by using multiples of median (MoM) of CL adjusted for gestational age. Results Of 796 participants, the mean midtrimester CL was 40 ± 6 mm with a 1st, 5th, and 10th percentile of 25, 29, and 32 mm, respectively. ROC curve analyses suggest that a cut-off of 30 mm was the optimal CL to predict sPTB before 35 weeks (area under the ROC curve [AUC]: 0.70, 95% confidence interval [CI]: 0.56–0.85) and before 37 weeks (AUC: 0.70, 95% CI: 0.59–0.80). Midtrimester CL <30 mm could detect 35% of all sPTB before 35 weeks at a false-positive rate of 5% (relative risk: 9.1, 95% CI: 3.5–23.5, p < 0.001). We observed similar results using a cut-off of CL <0.75 MoM adjusted for gestational age. Conclusion A midtrimester CL cut-off of 30 mm (instead of 25 mm), or CL less than 0.75 MoM, should be used to identify nulliparous women at high risk of sPTB. Key Points

Cervical Length Surveillance After 24 Weeks in Women With a History of Spontaneous Preterm Birth [09K]

2020 ◽  
Vol 135 ◽  
pp. 116s
Author(s):  
Eboni Jones ◽  
Kari Whitley ◽  
Joanne Quinones ◽  
Danielle Durie ◽  
Katherine Fradeneck
Keyword(s):  
Preterm Birth ◽  
Cervical Length ◽  
Spontaneous Preterm Birth ◽  
History Of
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