Sonographic longitudinal cervical length measurements in nulliparous women at term: prediction of spontaneous onset of labor
| Autor: | M. Meijer-Hoogeveen, G. H. A. Visser, P. Stoutenbeek, I. van der Tweel, C. Van Holsbeke |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Pediatrics medicine.medical_specialty Supine position Attitude of Health Personnel Pregnancy Trimester Third Population Pain Cervix Uteri Sensitivity and Specificity Pregnancy Maternity and Midwifery medicine Humans Radiology Nuclear Medicine and imaging education Physical Examination Pain Measurement Gynecology education.field_of_study Fetus Radiological and Ultrasound Technology business.industry Obstetrics Cephalic presentation Ultrasound Obstetrics and Gynecology General Medicine Middle Aged medicine.disease Term (time) Cervical Length Measurement Parity Reproductive Medicine Patient Satisfaction Pregnancy Trimester Second Pediatrics Perinatology and Child Health Feasibility Studies Labor Onset Gestation Female business |
| Zdroj: | Ultrasound in Obstetrics and Gynecology. 32:652-656 |
| ISSN: | 1469-0705 0960-7692 |
| DOI: | 10.1002/uog.5291 |
| Popis: | Objective The aim of this study was to predict spontaneous onset of labor by serial transvaginal ultrasound measurement of cervical length (CL) in a homogeneous population of nulliparous women at term. Methods 162 nulliparous women with singleton fetuses in cephalic presentation were examined at weekly intervals from 36 weeks' gestation to delivery. CL was measured by transvaginal ultrasound in the supine and upright positions. Results There was a significant decrease in CL in the last 12 days prior to delivery. However, this decrease was small with substantial variation between individuals. Women with spontaneous onset of labor could be divided into three different groups: those with unchanged CL before delivery; those with a fall in CL in the last 2 weeks prior to delivery; and those with a gradual change in CL starting before the last 2 weeks prior to delivery. A single CL measurement below 30 mm between 37 and 38 weeks of gestation predicted spontaneous onset of labor before 41 weeks' gestation with a sensitivity of 46%, specificity of 78%, positive predictive value (PPV) of 82%, negative predictive value (NPV) of 40% in the supine position; and sensitivity of 53%, specificity of 72%, PPV of 81%, NPV of 40% in the upright position. Conclusion Between 37 and 38 weeks' gestation, spontaneous onset of labor before 41 weeks can be predicted by a CL measurement, but with low sensitivity and NPV. Inter-individual variations in CL and in CL changes are large, which hampers the value of single and repeated CL measurements for the prediction of spontaneous onset of labor at term. Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd. |
| Databáze: | OpenAIRE |
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