Routine transabdominal cervical length screening in mid‐pregnancy for the prevention of preterm birth: Is it good enough to use as a screening test?

Author:

Pedretti Michelle K12ORCID,Dickinson Jan E.13ORCID,Doherty Dorota A.1ORCID,Newnham John P.1ORCID

Affiliation:

1. Division of Obstetrics and Gynaecology The University of Western Australia Perth Western Australia Australia

2. Department of Ultrasound King Edward Memorial Hospital Perth Western Australia Australia

3. Maternal Fetal Medicine Service King Edward Memorial Hospital Perth Western Australia Australia

Abstract

BackgroundPreterm birth (PTB) is a major pregnancy complication. There is evidence that a short cervical length in mid‐pregnancy may predict women at increased risk of PTB.AimsTo evaluate the utility of population‐based, transabdominal cervical length (TACL) measurement screening in mid‐pregnancy for PTB prediction in women.Materials and MethodsA transabdominal approach was initially performed, with a transvaginal (TVCL) approach offered when the TACL was <35 mm, could not be accurately measured, or the pregnancy had risk factors for PTB. TACL was compared to the directly related TVCL, when both were performed at the same assessment. Women with risk factors of PTB were included when they had both TACL and TVCL measurements performed at the same visit.ResultsData were provided for 9355 singleton pregnancies from 13 participating imaging centres. A transabdominal approach was used in 9006 (96.3%), including 682 (7.3%) TVCL combined with TACL. There were 349 (3.7%) women who had TVCL only. The median TACL was longer (40 mm) than the TVCL (38 mm). In 682 paired TACL and TVCL measurements, TACL <35 mm correctly identified 96.2% of pregnancies with TVCL <25 mm, compared with 65.4% of cases when using a TACL <30 mm. A TVCL <25 mm occurred in 59 (0.6%) women. A TACL <35 mm was associated with birth <37 weeks of gestation in 12.1% of women and birth <32 weeks of gestation in 3.9%.ConclusionsUniversal TACL is a feasible option for population screening of cervical length in a low‐risk population, progressing to TVCL if the TACL is <35 mm or the cervix cannot be transabdominally accurately measured.

Publisher

Wiley

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3