Cervical length at 23 weeks in twins in predicting spontaneous preterm delivery

AbstractThe objective of our study was to evaluate the correlation of the cervical length at 20–25 weeks of gestation with the incidence of spontaneous preterm delivery in twins in a country with a high incidence of preterm delivery compared to other European countries. Cervical length was measured in 262 consecutive patients. Previous preterm delivery before 34 weeks of gestation, chorionicity, maternal age, body-mass-index, smoking habit and parity were recorded as risk factors for preterm delivery. Women who were symptomatic at 20–25 weeks and who delivered because of other reasons than spontaneous labour and preterm rupture of membranes or at term were excluded. The primary outcome was incidence of preterm birth before 34 weeks. Two hundred and twenty-three patients were analyzed. Thirty-two (14%) delivered before 34 weeks. There was a significant correlation between cervical length of less than 25 mm and spontaneous delivery before 34 weeks (50% vs. 13%,p= .007). In addition, logistic regression analysis found cervical length to be the only significant predictor of spontaneous delivery before 34 weeks (OR 1.084; 95% CI 1.015; 1.159;p= .017). We conclude that the risk of severe preterm delivery in twins is high. Cervical length at mid-gestation was the only predictor of delivery before 34 weeks.

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Effect of second‐trimester sonographic cervical length on the risk of spontaneous preterm delivery in different risk groups: a prospective observational multicenter study

Acta Obstetricia Et Gynecologica Scandinavica ◽

10.1111/aogs.14203 ◽

2021 ◽

Author(s):

Tove Wikström ◽

Henrik Hagberg ◽

Bo Jacobsson ◽

Pihla Kuusela ◽

Jan Wesström ◽

...

Keyword(s):

Preterm Delivery ◽

Multicenter Study ◽

Risk Groups ◽

Cervical Length ◽

Second Trimester ◽

Spontaneous Preterm Delivery

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EVALUATING THE EFFICIENCY OF MEASURING THE CERVICAL LENGTH AND FUNNELING BY TRANSVAGINAL SONOGRAM IN PREDICTION OF SPONTANEOUS PRETERM DELIVERY

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2018/533 ◽

2018 ◽

Vol 7 (19) ◽

pp. 2365-2371

Author(s):

Dhanalakshmi Kaliyamoorthy ◽

Gowri Arumugam Loganathan

Keyword(s):

Preterm Delivery ◽

Cervical Length ◽

Spontaneous Preterm Delivery

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A soft cervix, categorized by shear-wave elastography, in women with short or with normal cervical length at 18–24 weeks is associated with a higher prevalence of spontaneous preterm delivery

Journal of Perinatal Medicine ◽

10.1515/jpm-2018-0062 ◽

2018 ◽

Vol 46 (5) ◽

pp. 489-501 ◽

Cited By ~ 21

Author(s):

Edgar Hernandez-Andrade ◽

Eli Maymon ◽

Suchaya Luewan ◽

Gaurav Bhatti ◽

Mohammad Mehrmohammadi ◽

...

Keyword(s):

Cohort Study ◽

Preterm Delivery ◽

Shear Wave ◽

Wave Speed ◽

Shear Wave Elastography ◽

Cervical Length ◽

Singleton Pregnancy ◽

Short Cervix ◽

Shear Wave Speed ◽

Spontaneous Preterm Delivery

AbstractObjective:To determine whether a soft cervix identified by shear-wave elastography between 18 and 24 weeks of gestation is associated with increased frequency of spontaneous preterm delivery (sPTD).Materials and methods:This prospective cohort study included 628 consecutive women with a singleton pregnancy. Cervical length (mm) and softness [shear-wave speed: (SWS) meters per second (m/s)] of the internal cervical os were measured at 18–24 weeks of gestation. Frequency of sPTD <37 (sPTD<37) and <34 (sPTD<34) weeks of gestation was compared among women with and without a short (≤25 mm) and/or a soft cervix (SWS <25thpercentile).Results:There were 31/628 (4.9%) sPTD<37 and 12/628 (1.9%) sPTD<34 deliveries. The combination of a soft and a short cervix increased the risk of sPTD<37 by 18-fold [relative risk (RR) 18.0 (95% confidence interval [CI], 7.7–43.9); P<0.0001] and the risk of sPTD<34 by 120-fold [RR 120.0 (95% CI 12.3–1009.9); P<0.0001] compared to women with normal cervical length. A soft-only cervix increased the risk of sPTD<37 by 4.5-fold [RR 4.5 (95% CI 2.1–9.8); P=0.0002] and of sPTD<34 by 21-fold [RR 21.0 (95% CI 2.6–169.3); P=0.0003] compared to a non-soft cervix.Conclusions:A soft cervix at 18–24 weeks of gestation increases the risk of sPTD <37 and <34 weeks of gestation independently of cervical length.

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Association Between Cervical Length at 18-23 Weeks of Gestation and Spontaneous Preterm Delivery: A Cross Sectional Study

Case Reports in Obstetrics Gynecology and Reproductive ◽

10.31487/j.crogr.2020.03.02 ◽

2020 ◽

pp. 1-4

Author(s):

Trupti Ruge ◽

Emanuel Gracias

Keyword(s):

Preterm Birth ◽

Preterm Delivery ◽

Transvaginal Ultrasound ◽

Demographic Data ◽

Cross Sectional Study ◽

Cervical Length ◽

Sectional Study ◽

Cross Sectional ◽

Mortality And Morbidity ◽

Spontaneous Preterm Delivery

Introduction: Preterm birth is childbirth occurring at less than 37 completed weeks or 259 days of gestation, is a major determinant of neonatal mortality and morbidity and has long-term adverse consequences for health. Identifying ways to address preventable causes of preterm birth should be a top priority in developing regions of the world. the present study was planned to find the association between cervical length at 18 to 23 weeks of gestation done as a routine during all second level scans and spontaneous preterm delivery. Patients and Methods: This is a hospital based cross sectional study conducted during the period from January 2019 to December 2019. A total of 205 women presenting with singleton pregnancies between 18- 23 weeks of gestations were assessed by transvaginal ultrasound for the measurement of cervical length. Patients were interviewed and their demographic data such as age, obstetric index(GPALD), obstetric history such last menstrual period (LMP), estimated delivery date (EDD) and current pregnancy details such as BP, pulse rate, pallor, period of gestation, were recorded in a predesigned pro forma. Results: In a total of 205 subjects, the average age was found to be 23.26 ± 3.49 years with 52.2% of the women being primigravida. The mean gestation age at the time of enrollment was 20.72 ± 1.00 weeks with 33% of women showing a cervical length of 26-30 mm. The delivery outcome was found as 11% preterm, majority (89.27%) was term delivery. Conclusion: The present study showed that a significantly higher number of women with cervical length ≤ 30 mm (assessed at 18 to 23 weeks of gestation) had preterm labour compared to a woman with cervical length > 30 mm.

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Cervical Length as a Predictor of Preterm Delivery in an Unselected Cohort of Women with Twin Pregnancies

American Journal of Perinatology ◽

10.1055/s-0038-1676484 ◽

2018 ◽

Vol 36 (12) ◽

pp. 1288-1294 ◽

Cited By ~ 1

Author(s):

Clifton O. Brock ◽

Leslie A. Moroz ◽

Cynthia Gyamfi-Bannerman

Keyword(s):

Preterm Delivery ◽

Meta Analysis ◽

Area Under The Curve ◽

Positive Likelihood Ratio ◽

Cervical Length ◽

Prospective Data ◽

Spontaneous Preterm Delivery ◽

False Discovery ◽

Twin Pregnancies ◽

Unselected Cohort

Objective To determine the risk of spontaneous preterm delivery (SPTD) associated with transvaginal cervical length (TVCL) in an unselected cohort. Study Design This is a retrospective study of serial TVCLs in unselected twin gestations. Receiver operator curves for SPTD were constructed from TVCLs at 18, 20, 22, and 24 weeks. Prediction thresholds were determined using a false discovery rate of 10%. The risk of SPTD was compared with previously published, prospective data from a meta-analysis. Results A total of 1,228 women were included. SPTD occurred prior to 35 weeks in 232 (18.9%), 126 (10.3%), and 24 (2.0%) women prior to 35, 32, and 28 weeks. TVCL was most predictive at 22 weeks (area under the curve = 0.67). TVCL thresholds for predicting SPTD prior to 35, 32, and 28 weeks were 3.1, 3.0, and 2.9 cm. Compared with a previous meta-analysis, the risk of SPTD < 34, 32, and 28 weeks was lower (positive likelihood ratio 9.0 vs. 5.4, 10.1 vs. 5.9, and 9.6 vs. 4.3). Conclusion TVCL is modestly predictive of SPTD in twin gestations. Compared with previous prospective studies, this cohort has lower risk of SPTD at similar TVCLs.

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Predictive value of transvaginal cervical length in triplet pregnancies for spontaneous preterm delivery at ≤ 32 weeks

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/jmf.12.1.46.49 ◽

2002 ◽

Vol 12 (1) ◽

pp. 46-49 ◽

Cited By ~ 12

Author(s):

S. H. Poggi ◽

A. Ghidini ◽

H. J. Landy ◽

M. Alvarez ◽

J. C. Pezzullo ◽

...

Keyword(s):

Preterm Delivery ◽

Predictive Value ◽

Cervical Length ◽

Spontaneous Preterm Delivery

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The comparison of USG measured cervical length in pregnant women with previous induced abortion versus those who have not had an induced abortion

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20194374 ◽

2019 ◽

Vol 8 (10) ◽

pp. 4024

Author(s):

Harshita Naidu ◽

Nivedita Hegde ◽

Anjali M. ◽

Rohini Kanniga ◽

Akhila Vasudeva

Keyword(s):

Pregnant Women ◽

Preterm Delivery ◽

Transvaginal Ultrasound ◽

Induced Abortion ◽

Cervical Length ◽

Care Hospital ◽

Spontaneous Preterm Delivery ◽

Increased Risk ◽

Significant Difference ◽

History Of

Background: The majority of women who undergo induced abortion are young and of low parity. Hence, it is desirable to look for any association effects of induced abortion with future reproductive outcomes. In this study, we aim to compare ultrasound measured cervical length in pregnant women with previous induced abortion versus those who have not had an induced abortion.Methods: This was a prospective observational study performed at tertiary care hospital. Total of 400 patients were recruited, divided into two groups. Patients with an induced abortion in previous pregnancy were included as cases and those with no history were taken as controls. Cervical length was measured by transvaginal ultrasound in all participants at 11-14, 18-22 and 28-32 weeks. Pregnancies were followed up to note incidence of spontaneous preterm delivery, preterm pre labour rupture of membranes (PPROM), threatened preterm, and second trimester miscarriage.Results: Authors have found that there was no significant difference in the cervical length of pregnant patients with or without a history of prior induced abortions. In our study authors found that mean cervical length at 11-14weeks, 18-22 weeks, and 28-32 weeks was 3.47±0.126cm and 3.48±0.195cm; 3.44±0.296cm and 3.49±0.182cm; 3.36±0.477cm and 3.42±0.310cm respectively among cases and controls. However, there was a demonstrably increased risk of spontaneous preterm delivery, PPROM and threatened preterm in patients with a history of prior induced abortion.Conclusions: Authors conclude that previous induced abortion increases the risk of threatened preterm, PPROM, spontaneous preterm delivery in the subsequent pregnancy. But, this risk is not predictable by measuring cervical length as the mean cervical length remained the same in both the groups.

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