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 Uterocervical Angle Measurement Improves Prediction of Preterm Birth in Twin Gestation

2017 ◽  
Vol 35 (07) ◽  
pp. 648-654 ◽  
Author(s):  
Emily Tenbrink ◽  
Mitchell Onslow ◽  
Avinash Patil ◽  
Jordan Knight
Keyword(s):  
Preterm Birth ◽  
Transvaginal Ultrasound ◽  
Cervical Length ◽  
Angle Measurement ◽  
Spontaneous Preterm Birth ◽  
Increased Risk ◽  
The Mean ◽  
Gestational Age At Birth ◽  
Twin Pregnancies ◽  
Better Than

Objective Twin pregnancies are associated with an increased risk of spontaneous preterm birth. Our objective was to compare the performance of uterocervical angle to cervical length as predictors of spontaneous preterm birth in this population. Methods We conducted a retrospective cohort study of twin gestations at a single center from May 2008 to 2016 who received a transvaginal ultrasound for the evaluation of the cervix between 16 0/7 and 23 0/7 weeks. The primary outcome was prediction of preterm birth <28 and <32 weeks by uterocervical angle and cervical length. Results Among 259 women with twin gestation, the mean gestational age at birth was 34.83 ± 3.48 weeks. Receiver operator characteristic curves demonstrated optimal prediction of spontaneous preterm birth prior to 32 weeks at a uterocervical angle >110° (80% sensitivity, 82% specificity) [odds ratio (OR), 15.7 (95% confidence interval (CI), 7.2–34.4)] versus cervical length <20 mm (53% sensitivity, 85% specificity; p < 0.001, OR, 6.4 [95% CI, 2.3–17.8]) and similarly, prior to 28 weeks at a uterocervical angle >114° (OR, 24.3 [95% CI, 6.7–88.5]) compared with cervical length <20 mm (OR, 11.4 [95% CI, 3.5–36.7]). Conclusion Uterocervical angles >110° performed better than cervical length for the prediction of spontaneous preterm birth in twin gestations.

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.

Biomarkers and Cervical Length to Predict Spontaneous Preterm Birth in Asymptomatic High-Risk Women

2013 ◽  
Vol 122 (2, PART 1) ◽  
pp. 283-289 ◽  
Author(s):  
Jamie A. Bastek ◽  
Adi Hirshberg ◽  
Suchitra Chandrasekaran ◽  
Carter M. Owen ◽  
Laura M. Heiser ◽  
...  
Keyword(s):  
Preterm Birth ◽  
High Risk ◽  
Cervical Length ◽  
Spontaneous Preterm Birth ◽  
High Risk Women

scholarly journals Use of the Arabin pessary in women at high risk for preterm birth: long-term experience at a single tertiary center in Malaysia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rahana Abd Rahman ◽  
Ixora Kamisan Atan ◽  
Anizah Ali ◽  
Aida Mohd Kalok ◽  
Nor Azlin Mohamed Ismail ◽  
...  
Keyword(s):  
Preterm Birth ◽  
High Risk ◽  
Medical Center ◽  
Demographic Data ◽  
Cervical Length ◽  
Close Monitoring ◽  
Spontaneous Preterm Birth ◽  
Antenatal Corticosteroids ◽  
Cervical Surgery ◽  
Tertiary Center

Abstract Background Spontaneous preterm birth is a global issue that contributed to perinatal morbidities and mortalities worldwide. The study aimed to describe the experience at UKM Medical Center in managing women at high risk for spontaneous preterm birth using the Arabin pessary. Methods This is a retrospective observational study involving 58 pregnancies from 1st January 2013 to 31st December 2019. Inclusion criteria were previous mid-trimester miscarriage and/or preterm birth, previous cervical surgery or short cervical length on routine sonogram. The demographic data, characteristics of each pregnancy and details of outcomes and management were described. Results The majority of women were Malay with mean age and body mass index of 32.9 ± 4.2 years and 27.1 ± 6.3 kg/m2 respectively. The most frequent indications for Arabin pessary insertion were previous mid-trimester miscarriage (46.4%) and early preterm birth (17.2%). A total of 73.4% of these women had the pessary inserted electively at a mean cervical length of 31.6 ± 9.1 mm at median gestation of 15.0 weeks. They were managed as outpatient (56.9%), inpatient (24.1%) or mixed (19.0%) with combination of progestogen (81.0%) and 53.4% received antenatal corticosteroids. Spontaneous preterm birth at or more than 34 weeks gestation occurred in 74.1% with birthweight at or more than 2000 g (82.4%). Despite cervical funneling in 12 women (20.7%), 66.7% delivered at or later than 34 weeks gestation and 2 (16.7%) resulted in miscarriage. Conclusions Insertion of the Arabin pessary is beneficial to prevent spontaneous preterm birth in pregnant women who are at high risk. In particular, early insertion and close monitoring allows the best possible outcomes. Trial registration This study was retrospectively registered with ClinicalTrials.gov (NCT04638023) on 20/11/2020.

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