Prediction of labour onset in women who present with symptoms of preterm labour using cervical length
| Autor: | Xiaoqi Yong, Tiffany Tuck Chin Wong, Tai Wai Yeo, George Seow Heong Yeo, Janice Su Zhen Tung, Beatrice Jia Ying Lee, Joanne Mei Xin Chan, Ruochen Du |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Reproductive medicine Cervix Uteri Ultrasonography Prenatal 03 medical and health sciences 0302 clinical medicine Obstetric Labor Premature Pregnancy Risk Factors medicine Humans 030212 general & internal medicine Prospective Studies Prospective cohort study Morning Prediction of preterm labour 030219 obstetrics & reproductive medicine Receiver operating characteristic Obstetrics business.industry Preterm labour Transvaginal ultrasound Obstetrics and Gynecology Gynecology and obstetrics Cervical Length Measurement ROC Curve Sample size determination RG1-991 Gestation Labor Onset Premature Birth Female business Cervical length Threatened preterm labour Research Article |
| Zdroj: | BMC Pregnancy and Childbirth BMC Pregnancy and Childbirth, Vol 21, Iss 1, Pp 1-7 (2021) |
| ISSN: | 1471-2393 |
| Popis: | Background Diagnosis of preterm labour is difficult because initial symptoms and signs are often mild and may occur in continuing pregnancies. This study aims to investigate the utility of measuring cervical length, using transvaginal ultrasound, in women presenting to the delivery suite with symptoms of preterm labour. Methods This was a prospective cohort study performed in KK Women’s and Children’s Hospital, Singapore from September 2017 to July 2018. Women with singleton pregnancies, presenting with symptoms of contraction pain, between 24+ 0 to 36+ 6 weeks gestation, were included. Transvaginal ultrasound cervical length measurements were done at presentation to the labour ward, after four hours and in the following morning. The primary outcome of the study was delivery within 1 week. All statistical analyses were conducted with Microsoft Excel and Statistical Package for the Social Sciences. Results A total of 95 subjects were included. A one-millimeter increase in the 1st cervical length increases scan-to-delivery time by 0.802 days (p-value 0.003, CI 0.280–1.323). Receiver Operator Characteristic (ROC) curve analysis for prediction of delivery within 1 week showed an Area Under Curve (AUC) of 0.667, optimal cut-off value of 27.5mm (sensitivity 77.8 %, specificity 61.6 %). A one-millimetre increase in the 3rd cervical length increases scan-to-delivery time by 0.770 days (p-value 0.023, CI 0.108–1.432). ROC curve analysis for prediction of delivery within 1 week showed an AUC of 0.915, optimal cut-off value of 25.5mm (sensitivity 100 %, specificity 73.6 %). However, the change in cervical length over a period of 1 day was not significant in predicting delivery within 1 week. Conclusions Our results indicate that by using a cervical length cut off of 27.5mm at presentation, we would have predicted 77.8 % of deliveries within 1 week. If we were to repeat the cervical length scan the next day, with the same cut-off of 27.5mm, we would have predicted 100 % of deliveries within 1 week. In our study, measuring the transvaginal ultrasound cervical length is a reliable diagnostic test for delivery within 1 week. However, the results are limited by the small sample size. Further studies should be conducted with a larger sample size. |
| Databáze: | OpenAIRE |
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