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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Greenough, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, M.J.M.C. / Kurjak M.D., Asim / Lee, MD MPH MSCR, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland

6 Issues per year


IMPACT FACTOR 2013: 1.425

SCImago Journal Rank (SJR): 0.782
Source Normalized Impact per Paper (SNIP): 0.928

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Two-stage transvaginal cervical length screening for preterm birth in twin pregnancies

Carolina Hofmeister1 / Maria de Lourdes Brizot1 / Adolfo Liao1 / Rossana P.V. Francisco1 / Marcelo Zugaib1

1Department of Obstetrics, Hospital das Clínicas, School of Medicine, University of São Paulo, Brazil

Corresponding author: Carolina Hofmeister, MD Hospital das Clínicas da Universidade de São Paulo Obstetrícia Av Dr Eneas de Carvalho Aguiar 255 São Paulo SP 05409-010 Brazil

Citation Information: Journal of Perinatal Medicine. Volume 38, Issue 5, Pages 479–484, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: 10.1515/jpm.2010.088, July 2010

Publication History

Received:
2009-10-16
Revised:
2010-03-08
Accepted:
2010-04-30
Published Online:
2010-07-14

Abstract

Aim: To compare cervical length (CL) at 18–21 and 22–25 weeks' gestation in twin pregnancies in prediction of spontaneous preterm delivery and to examine cervical shortening.

Methods: Retrospective cohort study of CL measured at 18–21 and 22–25 weeks' gestation in twin pregnancies.

Results: Receiver operating characteristics (ROC) curve revealed area of 0.64 (95% CI 0.53–0.75) and 0.80 (95% CI 0.72–0.88) for measurements at 18–21 and 22–25 weeks, respectively (P≤0.001). Sensitivities of 33.3% and 23% and negative predicting value (NPV) of 97.3% and 86.8% for delivery at <28 and <34 weeks gestation were reached for measurements at 18–21 weeks. Sensitivities of 71.4% and 38.2% and NPV of 99.1% and 91.4% for delivery at <28 and <34 weeks' gestation were reached for measurements at 22–25 weeks. Cervical length shortening analysis showed an area under ROC curve of 0.81 (95% CI 0.73–0.89) and best cut-off was at ≥2 mm/week. Sensitivities of 80% and 60.8% and NPV of 98.9% and 90.6% for delivery at <28 and <34 weeks gestation were reached.

Conclusions: In twin gestations, assessment of CL at 22–25 weeks is better than assessment at 18–21 weeks to predict preterm delivery before 34 weeks. Cervical shortening at a rate of ≥2 mm/weeks between 18 and 25 weeks gestation was a good predictor of spontaneous preterm birth in this high-risk population.

Keywords: Cervical length measurement; cervix uteri growth and development; multiple; obstetric labor; pregnancy; premature; prenatal; ultrasonography

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