Evaluation of midtrimester cervical length thresholds for the prediction of spontaneous preterm birth

2021 ◽  
pp. 102287
Author(s):  
Paul Guerby ◽  
Alexandre Fillion ◽  
Jean-Charles Pasquier ◽  
Emmanuel Bujold
Keyword(s):  
Preterm Birth ◽  
Cervical Length ◽  
Spontaneous Preterm Birth

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

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

2017 ◽  
Vol 6 (6) ◽  
pp. 2323 ◽  
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.

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