scholarly journals Plasma progesterone, estradiol, and unconjugated estriol concentrations in twin pregnancies: Relation with cervical length and preterm delivery

2018 ◽  
Vol 98 (1) ◽  
pp. 86-94 ◽  
Author(s):  
Vilma L. Johnsson ◽  
Nina G. Pedersen ◽  
Katharina Worda ◽  
Elisabeth Krampl‐Bettelheim ◽  
Lillian Skibsted ◽  
...  

2008 ◽  
Vol 11 (5) ◽  
pp. 552-557 ◽  
Author(s):  
Katharina Klein ◽  
Hubertus Gregor ◽  
Kora Hirtenlehner-Ferber ◽  
Maria Stammler-Safar ◽  
Armin Witt ◽  
...  

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.



2018 ◽  
Vol 36 (12) ◽  
pp. 1288-1294 ◽  
Author(s):  
Clifton O. Brock ◽  
Leslie A. Moroz ◽  
Cynthia Gyamfi-Bannerman

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.





2003 ◽  
Vol 22 (S1) ◽  
pp. 170-170 ◽  
Author(s):  
A. Fichera ◽  
G. Spinetti ◽  
E. Mor ◽  
T. Frusca


2017 ◽  
Vol 56 (2) ◽  
pp. 188-191 ◽  
Author(s):  
Kei Tanaka ◽  
Kenji Yamada ◽  
Miho Matsushima ◽  
Tomoko Izawa ◽  
Seishi Furukawa ◽  
...  




2012 ◽  
Vol 15 (4) ◽  
pp. 516-521 ◽  
Author(s):  
Kyung Joon Oh ◽  
Kyo Hoon Park ◽  
Eun Ha Jeong ◽  
Sung Youn Lee ◽  
Aeli Ryu ◽  
...  

Aim: To determine whether or not the change in cervical length (CL) over time is valuable in predicting spontaneous preterm delivery (SPTD) in asymptomatic twin pregnancies with a normal mid-trimester CL (>25 mm). Methods: This was a prospective study including 190 consecutive asymptomatic twin gestations with a CL > 25 mm at 20–24 weeks. The women underwent an initial CL measurement at the time of routine ultrasound examination between 20 and 24 weeks’ gestation, followed 4–5 weeks later by a repeat CL measurement. The primary outcome measure was SPTD at <32 completed weeks’ gestation. Multicollinearity was a concern in the multivariable model since change in CL and follow-up CL were highly correlated. Results: The rate of SPTD at <32 weeks was 4.2%. Multiple logistic regression analyses demonstrated that the change in CL and the follow-up CL were significantly associated with SPTD before 32 weeks after adjusting for baseline covariate such as in vitro fertilization. The best cut-off values for the prediction of SPTD at <32 weeks’ gestation were 13% for the change in CL with a sensitivity of 87.5% and a specificity of 63.2%. There was no significant difference in the area under the receiver operating characteristic curves between the change in CL and the follow-up CL. Conclusions: A greater change in CL is a good predictor of SPTD in asymptomatic twin pregnancies with a normal mid-trimester CL. However, the change in CL cannot provide data beyond the follow-up CL. In the setting of a normal mid-trimester CL, a follow-up CL measurement should be considered in asymptomatic twin pregnancies.



Twin Research ◽  
2000 ◽  
Vol 3 (4) ◽  
pp. 213-216 ◽  
Author(s):  
JL Shapiro ◽  
R Kung ◽  
JFR Barrett

AbstractThe aim of this study was to determine the predictive value of cervical length as a risk factor for spontaneous pre-term birth in twin gestations. A retrospective chart review was carried out on patients with twin pregnancies referred to our multiples' clinic. Cervical length was measured by transvaginal ultrasonography. Patients with an indicated pre-term delivery or intervention were excluded from the analysis. Outcomes included preterm delivery < 28 and < 35 weeks gestation. After extracting the data, 2 × 4 tables were constructed. Likelihood ratios were then generated for cervical lengths ≤2.0 cm, ≤2.5 cm, ≤3.0 cm, and > 3.0 cm. Because of the limited number of measurements taken < 25 weeks gestation, we elected to collapse the tables, thereby achieving more meaningful results. For measurements taken before 30 weeks gestation, a shorter cervix did predict delivery < 28 weeks gestation (likelihood ratios for cervical lengths ≤2.0 cm, ≤2.5 cm, ≤3.0 cm, and > 3.0 cm were 4.43, 1.94, 0.97, and 1.02, respectively). The probability of preterm delivery < 35 weeks gestation increased with decreasing cervical length (likelihood ratios for cervical length ≤2.0 cm, ≤2.5 cm, ≤3.0 cm, and > 3.0 cm were 2.58, 1.66, 1.38, and 0.81, respectively). A shorter cervix measured before 30 weeks gestation was a stronger predictor of preterm delivery < 28 weeks compared to < 35 weeks gestation. Cervical length was not predictive of preterm delivery if measured after 30 weeks. Cervical length is predictive of preterm delivery < 28 weeks and < 35 weeks gestation when measured before 30 weeks gestation. No trend was seen when measured after 30 weeks gestation. A prospective study is currently underway to confirm these results. Twin Research (2000) 3, 213–216.





2012 ◽  
Vol 40 (S1) ◽  
pp. 45-46
Author(s):  
M. Hermann ◽  
B. Deloison ◽  
L. J. Salomon ◽  
N. E. Russell ◽  
Y. Ville


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