The Use of Mid-Pregnancy Cervical Length to Predict Preterm Birth in Brazilian Asymptomatic Twin Gestations.
| Autor: | Silva TV; Department of Obstetrics and Gynecology, School of Medicine, University of Campinas, Campinas, SP, Brazil.; CISAM Maternity Hospital, University of Pernambuco, Recife, PE, Brazil., Borovac-Pinheiro A; Department of Obstetrics and Gynecology, School of Medicine, University of Campinas, Campinas, SP, Brazil., França MS; Department of Obstetrics, Screening and Prevention of Preterm Birth Sector, Discipline of Fetal Medicine, Escola Paulista de Medicina, Federal University of Sao Paulo, São Paulo, SP, Brazil., Marquat KF; Department of Obstetrics and Gynecology, School of Medicine, University of Campinas, Campinas, SP, Brazil., Argenton JP; Department of Obstetrics and Gynecology, School of Medicine, University of Campinas, Campinas, SP, Brazil., Mol BW; Department of Obstetrics and Gynaecologic, Monash University, Clayton, Victoria, Australia.; Aberdeen Centre for Women's Health Research, University of Aberdeen, Aberdeen, United Kingdom., Pacagnella RC; Department of Obstetrics and Gynecology, School of Medicine, University of Campinas, Campinas, SP, Brazil. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia [Rev Bras Ginecol Obstet] 2023 Apr; Vol. 45 (4), pp. 171-178. Date of Electronic Publication: 2023 May 24. |
| DOI: | 10.1055/s-0043-1769467 |
| Abstrakt: | Objective: To describe a reference curve for cervical length (CL) in mid-trimester twin gestations using transvaginal ultrasound (TVU) and to investigate whether short CL increases spontaneous preterm birth (sPTB) in asymptomatic twin pregnancies. Methods: This was a prospective cohort study performed at 17 outpatient antenatal facilities of Brazil with women at 18 0/7 to 22 6/7 weeks of gestation who participated in a randomized clinical trial screening phase (P5 trial) between July 2015 and March 2019. TVU was performed to provide CL measurement in all screened women. Almost all women with CL ≤ 30 mm received vaginal progesterone 200mg/day and they were also randomized to receive cervical pessary or not. We considered data from the CL distribution among asymptomatic twin pregnancies and analyzed CL and its association with PTB generating receiver operating characteristics (ROC) curves and Kaplan-Meier curves. Results: A total of 253 pregnant women with twins were included in the distribution curve. The mean CL was 33.7 mm and median was 35.5mm. The 10th percentile was 17.8mm. We identified a PTB rate of 73.9% (187/253) with 33.6% of sPTB < 37 (85/253) and 15% (38/253) of sPTB < 34 weeks. The best cutoff point to predict sPTB < 37 was 24.15 mm. However, the ROC curve showed a poor performance (0.64). The Kaplan-Meier survival curves identified that only CL values ≤ 20mm were associated to sPTB < 34 weeks. Conclusion: A cutoff point of CL ≤ 20 mm can be interesting point to identify short cervix in Brazilian twin pregnancies. However, in Brazilian asymptomatic twin pregnancies, CL does not show a good performance to predict PTB. Competing Interests: The authors have no conflict of interests to declare. (Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).) |
| Databáze: | MEDLINE |
| Externí odkaz: |
|