468: The predictive value of obstetrical ultrasound for neonatal survival in preterm birth less than 26 weeks

The aim of this study was to assess the validity of the last menstrual period (LMP) estimate in determining pre and post-term birth rates, in a prenatal cohort from two Brazilian cities, São Luís and Ribeirão Preto. Pregnant women with a single fetus and less than 20 weeks' gestation by obstetric ultrasonography who received prenatal care in 2010 and 2011 were included. The LMP was obtained on two occasions (at 22-25 weeks gestation and after birth). The sensitivity of LMP obtained prenatally to estimate the preterm birth rate was 65.6% in São Luís and 78.7% in Ribeirão Preto and the positive predictive value was 57.3% in São Luís and 73.3% in Ribeirão Preto. LMP errors in identifying preterm birth were lower in the more developed city, Ribeirão Preto. The sensitivity and positive predictive value of LMP for the estimate of the post-term birth rate was very low and tended to overestimate it. LMP can be used with some errors to identify the preterm birth rate when obstetric ultrasonography is not available, but is not suitable for predicting post-term birth.

Download Full-text

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

Geburtshilfe und Frauenheilkunde ◽

10.1055/a-1486-7148 ◽

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.

Download Full-text

Predictive Value of Initial Cervical Length for Subsequent Cervical Length Shortening in Women with a Prior Preterm Birth

American Journal of Perinatology ◽

10.1055/s-0035-1564425 ◽

2015 ◽

Vol 33 (04) ◽

pp. 350-355

Author(s):

Lorie Harper ◽

Jeff Szychowski ◽

John Owen ◽

Akila Subramaniam

Keyword(s):

Preterm Birth ◽

Predictive Value ◽

Cervical Length

Download Full-text

Evaluation of the anterior cervical angle of the uterus to predict spontaneous preterm birth

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20172114 ◽

2017 ◽

Vol 6 (6) ◽

pp. 2323 ◽

Cited By ~ 4

Author(s):

Bijay Sur ◽

Sujata Misra ◽

Sanghamitra Dash

Keyword(s):

Preterm Birth ◽

Predictive Value ◽

False Negative ◽

False Negative Rate ◽

Cervical Length ◽

Small Sample ◽

Transvaginal Sonography ◽

P Value ◽

Spontaneous Preterm Birth ◽

Preterm Group

Background: This prospective observational study was conducted to evaluate the anterior cervical angle (ACA) of the uterus by transvaginal sonography (TVS) and to determine the feasibility to predict spontaneous preterm birth (PTB). The duration of the study was from December 2014-December 2016.The participants included 100 pregnant women with singleton pregnancy who were asymptomatic. They were enrolled after excluding all known risk factors of preterm birth.Methods: The ACA and cervical length were measured in all cases by transvaginal sonography either in the 1st trimester or 2nd trimester. All cases were followed and well documented with respect to the gestational age at delivery.Results: There was a significant risk of preterm labour in women with cervical length <2.5cm in the 2nd trimester with Odds Ratio 3.625, P value=0.001, sensitivity 75% and specificity 79.31%. The positive predictive value was 33.33% and negative predictive value 95.83%. The false positive rate was 20.65% and false negative rate 25%. The difference of mean cervical angle in women who delivered preterm and that of those who delivered at term, in the 1st trimester (preterm group 114.2°Vs term group 93.0°, P<0.001) and in the 2nd trimester (preterm group 127.66° Vs term group 103.65°, P <0.001) was significant. An ACA of 114.2° in the 1st trimester was associated with a risk of spontaneous preterm birth (P value 0.0065, sensitivity 90% and specificity 80%). An ACA of 127.66° in 2nd trimester was associated with a risk of spontaneous preterm birth (P value 0.0004, sensitivity 80%and specificity 88.23%).Conclusions: Despite the limitations of a small sample size, the results suggest that the anterior cervical angle has potential as a new predictor of spontaneous preterm birth especially when measured in the 1st trimester.

Download Full-text

Evaluation of quantitative fFn test in predicting the risk of preterm birth

Journal of Perinatal Medicine ◽

10.1515/jpm-2015-0414 ◽

2017 ◽

Vol 45 (1) ◽

Cited By ~ 4

Author(s):

Michela Centra ◽

Giuliana Coata ◽

Elena Picchiassi ◽

Luisa Alfonsi ◽

Samanta Meniconi ◽

...

Keyword(s):

Preterm Birth ◽

Diagnostic Accuracy ◽

Roc Curve ◽

Predictive Value ◽

Preterm Labour ◽

Signs And Symptoms ◽

Singleton Pregnancy ◽

Fetal Fibronectin ◽

Prediction Risk ◽

Risk Categories

AbstractObjective:To evaluate diagnostic accuracy of quantitative fetal fibronectin (qfFN) test in predicting preterm birth (PTB) risk <34 weeks’ gestation or within 14 days from testing. We explored the predictive potential of the test in five-predefined PTB risk categories based on predefined qfFN thresholds (<10, 10–49, 50–199, 200–499 and ≥500 ng/mL).Methods:Measurement of cervicovaginal qfFN with Rapid fFN 10Q System (Hologic) in 126 women with singleton pregnancy (23–33 weeks’ gestation) reporting signs and symptoms indicative of preterm labour (PTL).Results:For PTB prediction risk <34 weeks’ gestation, sensitivity decreased from 100% to 41.7% and specificity increased from 0% to 99.1% with increasing fFN thresholds. Positive predictive value (PPV) increased from 9.5% to 83.3% with increasing qfFN thresholds, while negative predictive value (NPV) was higher than 90% among the fFN-predefined categories. Diagnostic accuracy results showed an area under a receiving operator characteristic (ROC) curve of 84.5% (95% CI, 0.770–0.903). For delivery prediction within 14 days from the testing, sensitivity decreased from 100% to 42.8% and specificity increased from 0% to 100% with increasing fFN thresholds. Diagnostic accuracy determined by the ROC curve was 66.1% (95% CI, 0.330–0.902).Conclusions:The QfFN thresholds of tests are a useful tool to distinguish pregnant women for PTB prediction risk <34 weeks’ gestation.

Download Full-text

Predictive value of mid-trimester cervical measurement data combined with maternal demographic characteristics for twin preterm birth at < 32 weeks: a retrospective analysis and multicentre validation study

10.22541/au.159682247.72368404 ◽

2020 ◽

Author(s):

Mian Pan ◽

Jun Zhang ◽

Wenqiang Zhan ◽

Yanling Lin ◽

Danlin Yang ◽

...

Keyword(s):

Preterm Birth ◽

Retrospective Analysis ◽

Validation Study ◽

Predictive Value ◽

Measurement Data ◽

Demographic Characteristics

Download Full-text

The negative predictive value of cervical interleukin-6 for the risk assessment of preterm birth

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.3109/14767058.2013.783798 ◽

2013 ◽

Vol 26 (13) ◽

pp. 1278-1281 ◽

Cited By ~ 6

Author(s):

Alfredo Perales-Puchalt ◽

Maia Brik ◽

Vicente J. Diago ◽

Alfredo Perales

Keyword(s):

Risk Assessment ◽

Preterm Birth ◽

Negative Predictive Value ◽

Interleukin 6 ◽

Predictive Value

Download Full-text

Predictive Value of Mid-Trimester Cervical Measurement Data Combined With Maternal Characteristics for Twin Preterm Birth at < 32 Weeks: A Retrospective Analysis and External Validation Study

10.21203/rs.3.rs-153973/v1 ◽

2021 ◽

Author(s):

Jun Zhang ◽

Wenqiang Zhan ◽

Yanling Lin ◽

Danlin Yang ◽

Xiaoying Xue ◽

...

Keyword(s):

Preterm Birth ◽

Predictive Value ◽

False Positive Rate ◽

External Validation ◽

Measurement Data ◽

Cervical Length ◽

Spontaneous Preterm Birth ◽

Maternal Characteristics ◽

Individual Probability ◽

Twin Pregnancies

Abstract Objective The purpose of this study was to develop a dynamic model to predict the risk of spontaneous preterm birth at < 32 weeks in twin pregnancy. Methods Women with twin pregnancies were followed up from January 2017 to December 2019 in two tertiary medical centres—data from one were used to construct the model, and data from the other were used to evaluate the model. Data on maternal demographic characteristics, transvaginal cervical length and funnelling during 20–24 weeks were extracted. The prediction model was constructed with independent variables determined by logistic regression analyses. Results After applying specified exclusion criteria, an algorithm with maternal and biophysical factors was developed based on 92 twin pregnancies with a preterm birth < 32 weeks and 672 twin pregnancies with a delivery ≥ 32 weeks. It was then evaluated among 36 pregnancies with a preterm birth < 32 weeks and 261 pregnancies with a delivery ≥ 32 weeks in a second tertiary centre without specific training. The model reached a sensitivity of 78.26%, specificity of 88.84%, false positive rate of 11.16% and negative predictive value of 96.76%; ROC characteristics proved that the model was superior to any single parameter with an AUC of 0.856. Conclusions We developed and validated a dynamic nomogram model to predict the individual probability of early preterm birth in order to better represent the complex aetiology of twin pregnancies and hopefully improve the prediction and indication of interventions.

Download Full-text