scholarly journals Screening vs no screening for preterm delivery in low risk singleton pregnancies

2021 ◽  
Author(s):  
Athena Souka ◽  
Vasiliki Areti Maritsa ◽  
Makarios Eleftheriades
Keyword(s):  
Preterm Delivery ◽  
Study Groups ◽  
Cervical Length ◽  
Low Risk ◽  
Cervical Cerclage ◽  
Spontaneous Preterm Delivery ◽  
Vaginal Progesterone ◽  
Propensity Analysis ◽  
Lower Hazard ◽  
Singleton Pregnancies

Introduction: To compare the effect of a policy of screening for spontaneous preterm delivery (SPD) by transvaginal cervical length (CL) measurement versus a no screening policy in the prevention of severe prematurity. Methods: Retrospective study on low risk singleton pregnancies examined at 20-24 weeks. Two cohorts one with SPD screening and the other without screening were matched using propensity analysis to create the study groups. Women with short CL were treated with vaginal progesterone and/or cervical cerclage/pessary. The outcomes examined were SPD<32 weeks (SPD 32) and SPD between 20 and 32 weeks (SPD 20-32). Results: Screening for SPD was associated with a significant reduction in the rate of SPD at less than 32 weeks (0.3% vs 0.8%, p=0.001 in the screened and no screened pregnancies respectively) and in the rate of SPD 20-32 (0.3% vs 0.9%, p=0.005 in the screened and no screened pregnancies respectively). After adjusting for maternal age, parity, body mass index, smoking and mode of conception, the screening group had significantly lower hazard for SPD 20-32 (HR=0.36, 95% CI: 0.18-0.75, p=0.006) and SPD32 (HR=0.39, 95% CI: 0.19-0.82, p=0.013). Conclusion: Screening for SPD by transvaginal CL measurement in mid pregnancy may reduce the incidence of severe prematurity in low risk singleton pregnancies.

Prediction of Preterm Delivery by Late Cervical Length Measurement after 24 Weeks

2015 ◽  
Vol 38 (3) ◽  
pp. 200-204 ◽  
Author(s):  
Ioannis Papastefanou ◽  
Athanasios Pilalis ◽  
Makarios Eleftheriades ◽  
Athena P. Souka
Keyword(s):  
Preterm Delivery ◽  
Transvaginal Ultrasound ◽  
False Positive Rate ◽  
Cross Sectional Study ◽  
Cervical Length ◽  
Low Risk ◽  
Cross Sectional ◽  
Spontaneous Preterm Delivery ◽  
Positive Rate ◽  
Singleton Pregnancies

Objective: To examine the value of the cervical length (CL) measurement at 24-30 gestational weeks in the prediction of spontaneous preterm delivery (SPD) between 30 and 34 weeks (SPD34) and between 34 and 37 weeks (SPD37). Methods: We performed a prospective cross-sectional study. CL was measured once by transvaginal ultrasound examination between 24 and 30 weeks. Results: The study sample consisted of 1,180 low-risk singleton pregnancies. 10 women (0.85%) had a SPD34 and 60 (5.08%) had a SPD37. CL was shorter (p < 0.001) in the women who had a SPD34 (median 11 mm) compared to the women who delivered after 34 weeks (median 31 mm). CL was shorter (p < 0.001) in the women who had a SPD37 (median 22 mm) compared to the women who delivered after 37 weeks (median 31 mm). CL predicted SPD34 (OR = 0.837, R2 = 0.2768, AUC = 0.9406, p < 0.001) and SPD37 (OR = 0.907, R2 = 0.1085, AUC = 0.7584, p < 0.001). The model achieved a sensitivity of 70.0 and 38.3% for 10% false-positive rate for SPD34 and SPD37, respectively. Conclusions: CL after 24 weeks is significantly shorter in women destined to have a SPD. In low-risk singleton pregnancies CL performs very well in predicting SPD34 and adequately in predicting SPD37.

scholarly journals EP03.05: Transvaginal sonographic cervical length in 11–14 weeks of gestation in a low‐risk population and risk of spontaneous preterm delivery

2019 ◽  
Vol 54 (S1) ◽  
pp. 246-246
Author(s):  
R. Garcia Rodriguez ◽  
A. Romero Requejo ◽  
Y. Emergui Zrihen ◽  
R. Garcia‐Delgado ◽  
D. Marrero Gil ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Cervical Length ◽  
Low Risk ◽  
Risk Population ◽  
Spontaneous Preterm Delivery

Comparison of a novel test for placental alpha microglobulin-1 with fetal fibronectin and cervical length measurement for the prediction of imminent spontaneous preterm delivery in patients with threatened preterm labor

2015 ◽  
Vol 43 (4) ◽  
Author(s):  
Tanja Nikolova ◽  
Oleg Bayev ◽  
Natasha Nikolova ◽  
Gian Carlo Di Renzo
Keyword(s):  
Preterm Delivery ◽  
Transvaginal Ultrasound ◽  
Cervical Length ◽  
Fetal Fibronectin ◽  
Spontaneous Preterm Delivery ◽  
Bedside Test ◽  
Study Population ◽  
Threatened Preterm Labor ◽  
Singleton Pregnancies ◽  
Spontaneous Delivery

AbstractPartoSure is a bedside test for the prediction of time-to-spontaneous preterm delivery by the detection of placental alpha microglobulin-1 (PAMG-1). The objectives of this study were to further determine the test’s efficacy in predicting delivery within 7 or 14 days from testing, and to compare it with fetal fibronectin (fFN) and cervical length (CL) measurement by transvaginal ultrasound.The study population consisted of 203 consecutively recruited women with singleton pregnancies between 20The sensitivities for PartoSure (n=203), fFN (n=66), and CL (n=203) for predicting imminent spontaneous preterm delivery within 7 days were 80%, 50%, and 57%, respectively. The specificities were 95%, 72%, and 73% for PartoSure, fFN and CL, respectively. The NPVs were 96%, 87%, and 89% for PartoSure, fFN and CL, respectively. The PPVs were 76%, 29%, and 30% for PartoSure, fFN and CL, respectively.PAMG-1 detection by PartoSure is the single best predictor of imminent spontaneous delivery within 7 days compared to fFN and CL. In settings where CL is used as an initial screen, PartoSure has the greatest clinical utility in patients with CL between 15 and 35 mm. In situations where CL is not an initial screen, PartoSure is the most accurate test compared to fFN and CL.

scholarly journals Transvaginal Ultrasound-indicated Cervical Cerclage Versus Vaginal Progesterone in Singleton Women with a Short Cervical Length: A Retrospective Study

2021 ◽  
Author(s):  
Yijun Liu ◽  
Tiantian Cao ◽  
Shuai Zeng ◽  
Ruixin Chen ◽  
Xinghui Liu ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Transvaginal Ultrasound ◽  
Latency Period ◽  
Preterm Births ◽  
Cervical Length ◽  
Secondary Outcome ◽  
Cervical Cerclage ◽  
Primary Methods ◽  
Vaginal Progesterone ◽  
Singleton Pregnancies

Abstract Introduction: Cervical cerclage and vaginal progesterone are two primary methods for preventing preterm birth. However, their effectiveness in preventing singleton pregnancies with a short cervical length is unclear. We compared the effects of cervical cerclage and vaginal progesterone on the mother and neonate in asymptomatic singleton pregnancies in women with a cervical length between 10–30 mm.Material and Methods: Asymptomatic singleton pregnant women with a cervical length of 10–30 mm, measured using transvaginal ultrasound at 12–26 weeks of gestation, who delivered at our hospital were enrolled. The primary outcome measure was preterm birth at <37, 34, 32, and 28 weeks of gestation. The secondary outcome measures were neonatal mortality, latency period from diagnosis to delivery, hemorrhage during delivery, birth weight, and cesarean delivery.Results: In the unadjusted analysis, the number of preterm births was significantly higher in the cerclage group than in the vaginal progesterone group. After multivariate adjustment for confounding factors, this relationship narrowed. The latency period from diagnosis to delivery was significantly prolonged.Conclusions: Cervical cerclage showed no benefit over vaginal progesterone in preventing preterm birth. However, it prolonged gestational age by 39 days compared to vaginal progesterone treatment.

scholarly journals 13: Implementation of universal cervical length screening is associated with a reduction in the rate of spontaneous preterm delivery in a low-risk cohort

2017 ◽  
Vol 216 (1) ◽  
pp. S10 ◽  
Author(s):  
Pooja Mittal Green ◽  
Alex Argyelan ◽  
Francis Mutual ◽  
Johnna Nynas ◽  
Jennifer Williams ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Cervical Length ◽  
Low Risk ◽  
Spontaneous Preterm Delivery

scholarly journals The Feasibility of Cervical Elastography in Predicting Preterm Delivery in Singleton Pregnancy with Short Cervix Following Progesterone Treatment

2021 ◽  
Vol 18 (4) ◽  
pp. 2026
Author(s):  
Yun Ji Jung ◽  
Hayan Kwon ◽  
Jeongeun Shin ◽  
Yejin Park ◽  
Seok-Jae Heo ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Fold Increase ◽  
Cervical Length ◽  
Singleton Pregnancy ◽  
Short Cervix ◽  
Spontaneous Preterm Delivery ◽  
Progesterone Treatment ◽  
Singleton Pregnancies

Previous studies demonstrated an association between cervical strain and risk of spontaneous preterm delivery (sPTD). The present study aimed to assess the efficacy of elastography in predicting sPTD at <32 weeks of gestation in women with singleton pregnancies receiving progesterone for short cervix (≤2.5 cm) diagnosed between 16 and 28 weeks of gestation Among 115 participants eligible for analysis, nine had sPTD at <32 weeks. Preprogesterone (PP0) mean internal os strain (IOS), elasticity contrast index (ECI), hardness ratio (HR), one-week postprogesterone (PP1) IOS, mean external os strain (EOS), ECI, and HR were significantly different between groups. Higher PP0 IOS, PP1 IOS, and PP1 EOS were associated with a 2.92, 4.39 and 3.65-fold increase in the risk of sPTD at <32 weeks, respectively (adjusted for cervical length (CL) at diagnosis; p = 0.04, 0.012 and 0.026, respectively). A combination of CL at diagnosis, PP0 IOS and PP1 EOS showed a significantly higher area under the receiver operating characteristic curve (0.858) than that of CL alone (p = 0.041). In women with singleton pregnancies receiving progesterone for short cervix, cervical elastography performed before and one week after progesterone treatment may be useful in predicting sPTD at <32 weeks of gestation.

Prediction of Spontaneous Preterm Delivery in Twin Pregnancies By Cervical Length at Mid-Gestation

2008 ◽  
Vol 11 (5) ◽  
pp. 552-557 ◽  
Author(s):  
Katharina Klein ◽  
Hubertus Gregor ◽  
Kora Hirtenlehner-Ferber ◽  
Maria Stammler-Safar ◽  
Armin Witt ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Smoking Habit ◽  
Cervical Length ◽  
Spontaneous Preterm Delivery ◽  
Spontaneous Labour ◽  
High Incidence ◽  
High Cervical ◽  
Twin Pregnancies ◽  
Preterm Rupture Of Membranes ◽  
Spontaneous 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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