Evaluation of uterine cervix with transvaginal ultrasonography in women with threatened preterm labor and or preterm labor

Background: Preterm delivery can be associated with substantial perinatal morbidity and mortality. Nearly in 5 to 13% of pregnancies, happening deliveries are preterm before 37 weeks' gestation. Thus, prediction of preterm labor in parturient can provide a window of opportunity to prevent these complications and to be better prepared to deal with them. Hence the current study has been conducted with an objective to assess the efficiency of cervical length and funneling as assessed by transvaginal ultrasonography in predicting preterm labor.Methods: The current study was a prospective study, conducted in the Department of Obstetrics Emergencies, Dhanalakshmi Srinivasan Medical College and Hospital between November 2015 to April 2017. The study population included 60 women with singleton pregnancy of gestational age between 28 + 0 and 36 + 6 weeks and with painful and regular contractions (>1/10 min for at least 1 hour). Cervical length, funnelling length measured at presentation and after 48 hours were considered as predictor variables. The outcomes of interest were delivery within 1 week, delivery before 37 weeks and delivery before 34 weeks.Results: There was a statistically significant difference in cervical length and funnelling length between term and preterm groups at the time of diagnosis and after 48 hours (P <0.001). The positive predictive value increased from 33.3% to 100% with cervical length ≤ 40 mm to ≤ 20 mm. The negative predictive value decreased from 100% to 79.2% with cervical length ≤40 mm to ≤20 mm. To predict a preterm delivery in threatened preterm delivery patients, the sensitivity of a cervical length of ≤25 mm was 77.7%, specificity was 95.2%, the positive predictive value was 87.5% and negative predictive value is 90.9%.Conclusions: Cervical length and funnelling as assessed by transvaginal ultrasonography are efficient in predicting preterm labor.

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Role of transvaginal ultrasound in predicting preterm labor in singleton pregnancies

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180172 ◽

2018 ◽

Vol 7 (2) ◽

pp. 561

Author(s):

Mehbooba Beigh ◽

Mohammed Farooq Mir ◽

Rifat Amin ◽

Simrath Shafi

Keyword(s):

Preterm Delivery ◽

Predictive Value ◽

Preterm Labor ◽

Transvaginal Ultrasound ◽

Cervical Length ◽

Spontaneous Preterm Birth ◽

Threatened Preterm Labor ◽

Length Changes ◽

A Prospective Study

Background: Preterm delivery (PTD) is a major cause of perinatal morbidity and mortality. Objective of present study was to identify the women at risk of preterm delivery with the help of trans-vaginal ultrasound by assessing cervical length changes, funneling of lower uterine segment, cervical dilatation.Methods: A prospective study was carried out over a period of 2 years on 50 patients with 24-36 weeks of gestation who clinically presented with signs of threatened preterm labor and were subjected to transvaginal sonographic measurement of cervical length.Results: Prediction of spontaneous preterm birth at <37 weeks of gestation with cervical length to be 2.75 cm has sensitivity of 95%, specificity of 96.5%, positive predictive value of 86.36% and negative predictive value of 98.7%.Conclusions: Transvaginal ultrasonography is the reliable, reproducible and objective method to assess cervix and to predict the risk of preterm delivery.

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The comparison of predictive value of cervical length in singleton spontaneous preterm labor with in vitro fertilization pregnancies: A cohort study

International Journal of Reproductive BioMedicine ◽

10.18502/ijrm.v19i1.8180 ◽

2021 ◽

Author(s):

Razieh Mohammad ◽

Mahvash Zargar ◽

Mojgan Barati ◽

Somayeh Ershadian

Keyword(s):

Cohort Study ◽

In Vitro Fertilization ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Preterm Labor ◽

Roc Analysis ◽

Cervical Length ◽

Vitro Fertilization

Background: Preterm labor (PTL) is one of the most important factors in neonatal mortality. Some studies have revealed a reverse relationship between cervical length (CL) and PTL, however, further evidence is needed to confirm it. Objective: To investigate the predictive value of CL in spontaneous and in vitro fertilization (IVF) pregnancies. Materials and Methods: This prospective cohort study was performed on 154 pregnant women from 16-26 wk of gestation with a singleton fetus in spontaneous delivery (n = 77) and IVF pregnancies (n = 77) and followed up until delivery. Women with multiple pregnancy, placenta previa, cerclage, and congenital anomalies were excluded from the study. The cut-off determination was done according to the Roc analysis. Results: The mean CL in term delivery and PTL groups were 37 ± 7 mm and 31 ± 6 mm, respectively (p < 0.001). The frequency of PTL in spontaneous and IVF pregnancies were 7.8% and 23.27%, respectively (p = 0.007). According to the Roc analysis, the best cut-off for normal pregnancy was ≤ 36 mm with the negative predictive value of 97.9%, the positive predictive value of 11.4%, sensitivity 83.3%, and specificity of 46.5%. While for the IVF group, the cut off was ≤ 30 mm, with a negative predictive value of 88.4%, a positive predictive value of 57.8%, sensitivity of 63.2%, and a specificity of 86%. Conclusion: In this study, IVF had a significant direct correlation with PTL. CL also had a significant indirect relationship with PTL. Key words: Cervix, IVF, Preterm delivery, PTL.

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Role of cervical length assessment at mid-trimester scan for predicting preterm births: An experience from Tertiary Hospital

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v8i4.32383 ◽

2020 ◽

Vol 8 (4) ◽

pp. 187-192

Author(s):

Suman Raj Tamrakar ◽

Rubina Shrestha

Keyword(s):

Preterm Delivery ◽

Predictive Value ◽

Preterm Births ◽

Tertiary Hospital ◽

Cervical Length ◽

Singleton Pregnancy ◽

Pattern Of Care ◽

Short Cervix ◽

Sensitivity Specificity ◽

A Prospective Study

Background: Ultrasound has revolutionized the pattern of care and management. Mid trimester ultrasound (transabdominal) is a valuable method for pregnant clients to predict preterm births. Objectives: To assess cervical length at 20 to 24 weeks obstetric scan for predicting risk of preterm delivery and to determine the sensitivity and specificity of assessing cervical length as a predictor of preterm delivery. Methodology: This is a prospective study conducted at a Tertiary Hospital. Pregnant clients with singleton pregnancy at 20 to 24 weeks were enrolled for transabdominal ultrasound for assessing cervical length as a predictor of preterm delivery. Results: Of 1027 pregnant clients screened, the mean age was 22.92±3.45. Mean gestational age during scan was 21+5 weeks of gestation. About 2.43% of clients were found to have short cervix < 2.5 cm with mean cervical length 3.8 cm. The risk of preterm delivery was almost two fold when cervical length was < 2.5 cm. The sensitivity, specificity, positive predictive value and negative predictive value to predict preterm delivery were 32%, 85.9%, 5.44% and 98.04% respectively. Conclusion: Assessment of the cervical length at mid-trimester can be useful tool for predicting risk of preterm delivery.

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PREDICTIVE VALUE OF LOW AT III LEVELS FOR THE OCCURRENCE OF IVH, IRDS AND DEATH IN PREMATURE NEONATES

10.1055/s-0038-1644268 ◽

1987 ◽

Author(s):

W van den Berg ◽

M Peters ◽

C Breederveld ◽

J W ten Cate ◽

J G Koppe

Keyword(s):

Positive Predictive Value ◽

Predictive Value ◽

Distress Syndrome ◽

Peripheral Vein ◽

Premature Neonates ◽

Significant Difference ◽

At Iii ◽

Diffuse Intravascular Coagulation ◽

Idiopathic Respiratory Distress Syndrome ◽

A Prospective Study

The observation of AT III deficiency in premature neonates with Idiopathic Respiratory Distress Syndrome (IRDS), suggests a positive predictive value for a poor outcome. The underlying diffuse intravascular coagulation could generate serious hemorrhagic complications like Peri/Intraventricular Hemorrhage (IVH).A prospective study was performed in consecutively born neonates to assess the predictive value of low AT III for theoccurrence of IVH, (gr. III/IV), IRDS, and death. Eighty-one neonates were included in the study during a period of 5 months. AT III levels were determined immediately after birth by a chromogenic substrate assay. Values in umbilical cord blood were identical with values in capillary or peripheral vein blood samples taken within 6 hours after birth. There was no correlation between AT III values and gestational age (r: 0.18). Twenty-four neonates with IRDS showed a mean AT III value of 0.23 U/ml (S. D. ± 0.07 U/ml) which was significantly lower than a mean AT III value of 0.35 U/ml (S. D. ± 0.1 U/ml) for neonates without IRDS (p ≺0.00005). When IVH gr. III/IV was diagnosed in neonates having IRDS (8/24) no significant difference in mean AT IIIact was observed with respect to jnean AT III levels of remaining neonates without this complication. No death occurred in neonates without IRDS. Mean AT IIIact (0.21 U/ml) in neonates with IRDS who died (9/24) was low compared with mean AT III levels of neonates with IRDS who survived (0.25 U/ml), but did not reach significance (p≻0.1). Assuming a critical value of AT III of 20% a positive predictive value of 89% for IRDS, 44% for IVH, and 56% for death was calculated. It is concluded that low AT Illact levels have a high predictive value for IRDS.

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Mid-arm and Chest Circumferences for Estimating Low Birthweight

Paediatrica Indonesiana ◽

10.14238/pi33.1-2.1993.24-31 ◽

2018 ◽

Vol 33 (1-2) ◽

pp. 24-31

Author(s):

Achmad Surjono

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Positive Predictive Value ◽

Predictive Value ◽

Low Birthweight ◽

Newborn Infants ◽

Roc Curves ◽

Strong Correlations ◽

Significant Difference ◽

A Prospective Study

A prospective study was conducted to assess the diagnostic performance of mid-arm and chest circumferences on low birth weights in 1033 singleton newborn infants. The proportion of low birth weight was 11.7%. Strong correlations on birth weight (P<0.001) were found for mid-arm (r-0.85) and chest (r=0.86) circumferences. A mid-arm circumference of ≤9,5 cm was considered as cut-off level for low birth weight, with a sensitivity of 0.818, specificity 0.956 and positive predictive value 0. 712. Whereas that of chest circumference wa ≤29.5 cm with a sensitivity of 0. 785, specificity 0.895 and positive predictive value 0.497. Receiver operating characteristic (ROC) curves were used to compare their diagnostic accuracy. The area under these two ROC(± SE) were 0.954 ± 0.011 for mid-arm and 0.945 ± 0.012 for chest circumferences, respectively. Both areas showed significant differences with the area under chance line. No statistically significant difference was found between the area under ROC of mid-arm and chest circumferences. The results showed that mid-arm and chest circumferences as simple and reliable measurements can be used in estimating low birth weight, in areas where the accurate weighing of newborn infants is not feasible.

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Endometrial assessment by transvaginal ultrasonography and correlation with histopathology among post menopausal women

Journal of Pathology of Nepal ◽

10.3126/jpn.v10i1.26936 ◽

2020 ◽

Vol 10 (1) ◽

pp. 1613-1617

Author(s):

Hari Kishor Shrestha ◽

Ram Chandra Adhikari ◽

Khadga Bahadur Shrestha

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Endometrial Thickness ◽

Transvaginal Ultrasonography ◽

Menopausal Women ◽

History Of ◽

Post Menopausal ◽

Sensitivity Specificity ◽

Age Range

Background: Transvaginal ultrasonography has increased the reliability of imaging diagnosis of women with endometrial pathologies and this technique has become widely used to evaluate endometrial thickness in women with postmenopausal bleeding. Materials and methods: 359 women presenting with history of at least three months amenorrhea were undergone transvaginal ultrasonography with measurement of endometrial thickness and uterine size. Endometrial biopsies were taken in 69 cases (19.2%) only. Results: The median age of patients was 53 years with the age range of 42 years to 81 years. Abdominal pain was the commonest symptoms followed by backache. 3/69 cases with histopathological diagnoses had normal sized uterus, while 66 cases had bulky (>6.0 cm) uterus. 58/69 cases showed > 5 mm thick endometrium and the endometrium was abnormal in 31/69 cases. The sensitivity, specificity, positive predictive value and negative predictive value of transvaginal ultrasonography to detect abnormal endometrium were 91.2%, 22.9%, 53.4% and 72.7% respectively. The sensitivity, specificity, positive predictive value and negative predictive value of transvaginal ultrasonography to detect endometrial hyperplasia and carcinoma were 100%, 17.5%, 10.3% and 100% respectively. Conclusions: Transvaginal sonographic evaluation of endometrial thickness and uterine size is useful for exclusion of endometrial pathology and to avoid unnecessary invasive surgical procedures.

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Comparison of transvaginal and transabdominal ultrasonography in the diagnosis of ectopic pregnancy

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v39i3.20309 ◽

2014 ◽

Vol 39 (3) ◽

pp. 104-108 ◽

Cited By ~ 1

Author(s):

MN Nahar ◽

MA Quddus ◽

A Sattar ◽

M Shirin ◽

A Khatun ◽

...

Keyword(s):

Positive Predictive Value ◽

Ectopic Pregnancy ◽

Negative Predictive Value ◽

Predictive Value ◽

Transvaginal Ultrasonography ◽

Histopathological Diagnosis ◽

College Hospital ◽

Diagnostic Modality ◽

Cross Sectional ◽

Transabdominal Ultrasonography

This cross sectional study was carried out in the department of Radiology and Imaging, Dhaka Medical College Hospital from July 2008 to June 2010 to compare the accuracy of transvaginal ultrasonography and transabdominal ultrasonography in the diagnosis of clinically suspected cases of ectopic pregnancy. Initially 60 patients with clinical suspicion of ectopic pregnancy were included in this study after analyzing selection criteria 30 patients underwent both transvaginal and transabdominal ultrasonography. Histopathological diagnosis was considered gold standard against which accuracies of two diagnostic modalities were compared. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of transabdominal ultrasonography as a diagnostic modality in evaluation of suspected ectopic pregnancy were 73.1%, 75%, 95%, 30% and 73.3% respectively where as transvaginal ultrasonography was found to have 92.3% sensitivity, 75% specificity, 96% positive predictive value, 60% negative predictive value and 90% accuracy. Transvaginal ultrasonography was superior to transabdominal ultrasonography in the evaluation of suspected ectopic pregnancies .so, transvaginal ultrasonography is important for early and accurate diagnosis of ectopic pregnancy. DOI: http://dx.doi.org/10.3329/bmrcb.v39i3.20309 Bangladesh Med Res Counc Bull 2013; 39: 104-108

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Evaluation of red blood cell parameters provided by the UF-5000 urine auto-analyzer in patients with glomerulonephritis

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2021-0287 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Genki Mizuno ◽

Masato Hoshi ◽

Kentaro Nakamoto ◽

Masayo Sakurai ◽

Kazuko Nagashima ◽

...

Keyword(s):

Positive Predictive Value ◽

Iga Nephropathy ◽

Negative Predictive Value ◽

Predictive Value ◽

Blood Cells ◽

Area Under The Curve ◽

Cell Parameters ◽

Significant Difference ◽

Low Sensitivity ◽

Cardinal Symptom

Abstract Objectives The microscopic examination of hematuria, a cardinal symptom of glomerulonephritis (GN), is time-consuming and labor-intensive. As an alternative, the fully automated urine particle analyzer UF-5000 can interpret the morphological information of the glomerular red blood cells (RBCs) using parameters such as UF-5000 small RBCs (UF-%sRBCs) and Lysed-RBCs. Methods Hematuria samples from 203 patients were analyzed using the UF-5000 and blood and urine chemistries to determine the cut-off values of RBC parameters for GN and non-glomerulonephritis (NGN) classification and confirm their sensitivity to the IgA nephropathy and non-IgA nephropathy groups. Results The UF-%sRBCs and Lysed-RBCs values differed significantly between the GN and NGN groups. The cut-off value of UF-%sRBCs was >56.8% (area under the curve, 0.649; sensitivity, 94.1%; specificity, 38.1%; positive predictive value, 68.3%; and negative predictive value, 82.1%), while that for Lysed-RBC was >4.6/μL (area under the curve, 0.708; sensitivity, 82.4%; specificity, 56.0%; positive predictive value, 72.6%; and negative predictive value, 69.1%). Moreover, there was no significant difference in the sensitivity between the IgA nephropathy and non-IgA nephropathy groups (87.1 and 89.8% for UF-%sRBCs and 83.9 and 78.4% for Lysed-RBCs, respectively). In the NGN group, the cut-off values showed low sensitivity (56.0% for UF-%sRBCs and 44.0% for Lysed-RBCs). Conclusions The RBC parameters of the UF-5000, specifically UF-%sRBCs and Lysed-RBCs, showed good cut-off values for the diagnosis of GN.

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Diagnostic Performance of a Smart Device With Photoplethysmography Technology for Atrial Fibrillation Detection: Pilot Study (Pre-mAFA II Registry) (Preprint)

10.2196/preprints.11437 ◽

2018 ◽

Author(s):

Yong-Yan Fan ◽

Yan-Guang Li ◽

Jian Li ◽

Wen-Kun Cheng ◽

Zhao-Liang Shan ◽

...

Keyword(s):

Atrial Fibrillation ◽

Positive Predictive Value ◽

Mobile Phone ◽

Negative Predictive Value ◽

Mobile Phones ◽

Predictive Value ◽

Normal Sinus Rhythm ◽

Smart Devices ◽

Smart Device ◽

Significant Difference

BACKGROUND Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. The asymptomatic nature and paroxysmal frequency of AF lead to suboptimal early detection. A novel technology, photoplethysmography (PPG), has been developed for AF screening. However, there has been limited validation of mobile phone and smart band apps with PPG compared to 12-lead electrocardiograms (ECG). OBJECTIVE We investigated the feasibility and accuracy of a mobile phone and smart band for AF detection using pulse data measured by PPG. METHODS A total of 112 consecutive inpatients were recruited from the Chinese PLA General Hospital from March 15 to April 1, 2018. Participants were simultaneously tested with mobile phones (HUAWEI Mate 9, HUAWEI Honor 7X), smart bands (HUAWEI Band 2), and 12-lead ECG for 3 minutes. RESULTS In all, 108 patients (56 with normal sinus rhythm, 52 with persistent AF) were enrolled in the final analysis after excluding four patients with unclear cardiac rhythms. The corresponding sensitivity and specificity of the smart band PPG were 95.36% (95% CI 92.00%-97.40%) and 99.70% (95% CI 98.08%-99.98%), respectively. The positive predictive value of the smart band PPG was 99.63% (95% CI 97.61%-99.98%), the negative predictive value was 96.24% (95% CI 93.50%-97.90%), and the accuracy was 97.72% (95% CI 96.11%-98.70%). Moreover, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of mobile phones with PPG for AF detection were over 94%. There was no significant difference after further statistical analysis of the results from the different smart devices compared with the gold-standard ECG (P>.99). CONCLUSIONS The algorithm based on mobile phones and smart bands with PPG demonstrated good performance in detecting AF and may represent a convenient tool for AF detection in at-risk individuals, allowing widespread screening of AF in the population. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR-OOC-17014138; http://www.chictr.org.cn/showproj.aspx?proj=24191 (Archived by WebCite at http://www.webcitation/76WXknvE6)

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The Value of Bacterial Culture During Clean Orthopedic Surgery a Prospective Study of 1,036 Patients

Infection Control and Hospital Epidemiology ◽

10.1086/502431 ◽

2004 ◽

Vol 25 (6) ◽

pp. 512-514 ◽

Cited By ~ 20

Author(s):

Louis Bernard ◽

Christophe Sadowski ◽

Daniel Monin ◽

Richard Stern ◽

Blaise Wyssa ◽

...

Keyword(s):

Positive Predictive Value ◽

Prospective Study ◽

Negative Predictive Value ◽

Orthopedic Surgery ◽

Predictive Value ◽

Postoperative Infection ◽

Bacterial Culture ◽

Bacterial Cultures ◽

Sensitivity Specificity ◽

A Prospective Study

AbstractObjective:To determine whether bacterial cultures of the wounds of patients undergoing clean orthopedic surgery would help predict infection.Methods:During 1 year, 1,256 cultures were performed for 1,102 patients who underwent clean orthopedic surgery. Results were analyzed to evaluate their ability to predict postoperative infection.Results:The sensitivity, specificity, positive predictive value, and negative predictive value of the cultures were 38%, 92%, 7%, and 99%, respectively.Conclusions:Cultures performed during clean orthopedic surgery were not useful for predicting postoperative infection.

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