Evaluation of quantitative ultrasound tissue characterization of the cervix and cervical length in the prediction of premature delivery for patients with spontaneous preterm labor
| Autor: | Günther Heller, Stephan Schmidt, Annette Römer, I. Tekesin, Lars Hellmeyer, Maritta Kühnert |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
medicine.medical_specialty Bishop score Cervix Uteri Obstetric Labor Premature Text mining Predictive Value of Tests Pregnancy Odds Ratio Humans Medicine Cutoff Cervix Cervical length Ultrasonography Gynecology business.industry Obstetrics and Gynecology Odds ratio Delivery Obstetric Prognosis Quantitative ultrasound medicine.anatomical_structure ROC Curve Multivariate Analysis Gestation Female business |
| Zdroj: | American Journal of Obstetrics and Gynecology. 189:532-539 |
| ISSN: | 0002-9378 |
| Popis: | OBJECTIVE: This study was to evaluate the predictive value of the uterine cervix tissue with the use of quantitative ultrasound gray level analysis for preterm delivery. STUDY DESIGN: Sixty-eight patients with preterm labor between 20 and 35 weeks of gestation were included. When two-dimensional transvaginal ultrasound measurement of cervical length was completed, a region of interest of constant size was defined in the midsection of the posterior wall, and the tissue-specific gray scale was determined. Preterm delivery of RESULTS: Twenty-eight patients (41.2%) were delivered preterm. The risk for preterm delivery was increased significantly in patients with cervical length of ≤2.5 cm (odds ratio, 7.67; 95% CI, 2.4-24.45), with Bishop score of ≥4 (odds ratio, 3.44; 95% CI, 1.21-9.75), and with decreased mean gray scale value (odds ratio, 12.13; 95% CI, 3.69-39.88). Parity and uterine contractions were not significant as predictors for preterm delivery, although the risk for preterm delivery increased with higher parity (odds ratio, 1.8; 95% CI, 0.68-4.79). The risk for preterm delivery remained nearly the same by uterine contractions (odds ratio, 0.92; 95% CI, 0.28-3.01). A mean scale value of ≤6.54 had the best cutoff value for the prediction of preterm delivery. For preterm delivery, a mean gray value ≤6.54 had a sensitivity of 82.1%, a specificity of 72.5%, a positive predictive value of 67.6%, and a negative predictive value 85.3%. Multiple logistic regression analysis indicated that, even when other variables are considered simultaneously, the mean gray scale value is the single best predictor of preterm delivery. CONCLUSION: Quantitative ultrasound tissue characterization of the uterine cervix predicts premature delivery and provides additional information in the prediction of potential premature delivery. |
| Databáze: | OpenAIRE |
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