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P369: Ultrasound cervical length to predict spontaneous preterm delivery in twin pregnancies
Author(s) -
Fichera A.,
Spinetti G.,
Mor E.,
Frusca T.
Publication year - 2003
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.839
Subject(s) - medicine , gestational age , gestation , preterm delivery , predictive value , obstetrics , twin pregnancy , ultrasound , cervical cerclage , pregnancy , predictive value of tests , gynecology , radiology , genetics , biology
Objective: To analyse the predictive value of different cervical lengthcut-offs for spontaneous preterm delivery <32 and <34 weeks intwin pregnancies.Methods: Transvaginal cervical ultrasound examinations wereperformed in 106 twin pregnancies between 20 and 26.6 weeks(January 2001 to January 2003). Sensitivity, specificity andpredictive values of cervical length (20, 25 mm) at 20–24 and24.1–26.6 weeks for the prediction of spontaneous preterm birth<32 and <34 weeks were calculated. Twin gestations electivelydelivered preterm because of maternal or fetal indications wereexcluded from this analysis.Results: The median gestational age at delivery was 35 weeks (range23.2–39.3). Cerclage was performed in 12 patients with cervicallength 25 mm or prolapse of membranes at a median gestational ageof 23 weeks (range 20.5–26.2). The rate of spontaneous delivery<32 and <34 weeks was 8.4% (9/106) and 13.2% (14/106)respectively. In the group of patients evaluated at 20–24 weeks,7/85 (8.2%) women delivered spontaneously <32 weeks and9/85 (10.6%) <34 weeks; in the group of patients evaluated at24.2–26.6 weeks, 2/66 (3%) delivered spontaneously <32 weeksand 7/66 (10.6%) <34 weeks. Cervical length at 20–24 weekswith a cut-off value 20 mm had specificities of 99% and 99%,sensitivities of 43% and 33%, negative predictive values of 95%and 92%, positive predictive values of 75% and 75% for delivery<32 and <34 weeks, respectively. Cervical length at 20–24 weekswith a cut-off value 25 mm had specificities of 95% and 94%,sensitivities of 43% and 33%, negative predictive values of 95%and 91%, positive predictive values of 43% and 43% for delivery<32 and <34 weeks, respectively.Conclusions: In twin gestations a cervical length 20 mm measuredat 20–24 weeks is the best cut-off to predict spontaneouspreterm delivery