Three-dimensional ultrasound assessment of the cervix for predicting time to spontaneous onset of labor and time to delivery in prolonged pregnancy
| Autor: | Povilas Sladkevicius, B. De Moor, Linas Rovas, F. De Smet, Lil Valentin, E. Strobel |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
medicine.medical_specialty Time Factors Bishop score Cervix Uteri Logistic regression Imaging Three-Dimensional Predictive Value of Tests Pregnancy medicine Humans Radiology Nuclear Medicine and imaging Pregnancy Prolonged Prospective Studies Prospective cohort study Cervix Gynecology Radiological and Ultrasound Technology Receiver operating characteristic Obstetrics business.industry Vaginal delivery Obstetrics and Gynecology Ultrasonography Doppler General Medicine medicine.disease medicine.anatomical_structure Logistic Models Reproductive Medicine ROC Curve Predictive value of tests Labor Onset Female business Cervical Ripening |
| Zdroj: | Ultrasound in obstetricsgynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 28(3) |
| ISSN: | 0960-7692 |
| Popis: | Objectives To determine whether three-dimensional (3D) ultrasound including power Doppler examination of the cervix is useful for predicting time to spontaneous onset of labor or time to delivery in prolonged pregnancy. Methods A prospective study was conducted in 60 women who went into spontaneous labor. All underwent transvaginal 3D power Doppler ultrasound examination of the cervix immediately before a prolonged-pregnancy cbeck-up at >= 41 + 5 gestational weeks. Univariate and multivariate logistic regression analysis was used to determine which of the following variables predicted spontaneous onset of labor > 24 h and > 48 h and vaginal delivery > 48 h and > 60 h: length, anteroposterior (AP) diameter and width of the cervix and of any cervical funneling; cervical volume (cm(3)); vascularization index (VI); flow index (FI); vascularization flow index (VEI); parity; and Bishop score. Multivariate logistic regression analysis was carried out both with and without Bishop score as a predictive variable. Receiver-operating characteristics (ROC) curves were used to describe the diagnostic performance of the tests. Results The areas under the ROC curves for Bishop score, cervical length, and logistic regression models did not differ significantly (areas ranging from 0.72 to 0.82). If Bishop score was not included in the logistic regression model, cervical length, VI and FI independently predicted delivery > 48 h, the likelihood increasing with increasing cervical length, decreasing VI and increasing FI. Conclusions In prolonged pregnancy cervical vascularization as estimated by 3D power Doppler ultrasound is related to time to delivery > 48 h, but the likelihood of delivery > 48 h can be predicted equally well using Bishop score alone or sonograpbic cervical length alone Copyright (c) 2006 ISUOG. Published by John Wiley & Sons, Ltd. (Less) |
| Databáze: | OpenAIRE |
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