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P05.01: Role of ultrasound cervical length and vaginal infections in predicting spontaneous preterm delivery in twin pregnancies
Author(s) -
Fichera A.,
Andrico A.,
Minelli A.,
Mor E.,
Frusca T.
Publication year - 2006
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.3576
Subject(s) - medicine , cervix , gestation , obstetrics , pregnancy , vagina , twin pregnancy , trichomonas vaginalis , ultrasound , gynecology , preterm delivery , surgery , radiology , cancer , biology , genetics
Objective: To evaluate the role of short cervix at ultrasound exami- nation and vaginal infection in predicting spontaneous early preterm delivery in twin pregnancies.Methods: Measurement of cervical length with ultrasound transvaginal (TV) probe was performed in 312 twin pregnan- cies between 19 and 25week’s gestation. Vaginal swabs at the same period were evaluated for all patients and the pres- ence of bacterial infection and/or trichomonas vaginalis was recorded. Patients with cervical length ≤ 20 mm and/or a diagnosis of vaginal infection were compared for preterm deliv- ery < 32 weeks with patients with normal cervical length and no signs of infections. Cerclage was performed in 20 patients with a cervical length ≤ 20 mm or prolapse of membranes < 25 weeks.Results: Data for 8 cases delivered <32weeks for fetal and/or maternal indications were excluded, leaving 304 patients for the analysis. Cervical length ≤ 20 mm was found in 25 patients (8.2%) and a diagnosis of vaginal infection was made in 72 cases (23.7%).Spontaneous preterm delivery < 32 weeks occurred in 24 patients (7.8%). Five cases with cervical length ≤ 20 mm (20%) and 19 patients with longer cervix (6.8%) delivered spontaneously < 32 weeks (p = 0.019). When considering vaginal infection, spontaneous preterm delivery <32weeks occurred in 6 patients with positive test (8.3%) and in 18 with negative test (8.3%) (p = 0.87). Only one patient out of 7 with both short cervix and positive test for infection delivered < 32 weeks (p = 0.52).Conclusions: Early spontaneous preterm delivery was significantly associated with short cervical length between 19 and 25 weeks’ gestation, while no correlation was found with a diagnosis of vaginal infection during pregnancy. In twin pregnancies spontaneous preterm delivery as well as shortening of the cervix have most likely different etiologies and cervical shortening is probably not related to infection