Identifying twin gestations at low risk for preterm birth with a transvaginal ultrasonographic cervical measurement at 24 to 26 weeks' gestation

Imseis, Hytham M.; Albert, Thomas A.; Iams, Jay D.

doi:10.1016/s0002-9378(97)70032-2

Cited by 128 publications

(63 citation statements)

References 9 publications

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“…The mean number of measurements per pregnancy was 5.3 ± 3.2 (range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Of the 494 (88.1%) subjects that had more than one measurement, the median times for the first and last cervical length measurements were the 19 th and 31 st weeks, respectively, and the mean interval between cervical length measurements was 2.4 ± 1.6 (range, 1-18) weeks.…”

Section: Resultsmentioning

confidence: 99%

Gestational age at cervical length measurement and preterm birth in twins

Ehsanipoor

Haydon

Gaffaney³

et al. 2012

Ultrasound in Obstet & Gyne

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Objectives (odds ratio (OR) 0.95 (95% CI,; P < 0.001) and by approximately 6% for each additional week at which the cervical length was measured (OR 0.94 (95% CI,; P < 0.001). ConclusionThe gestational age at which cervical length is measured is an important consideration when estimating the risk of spontaneous preterm birth in twins. The risk of preterm delivery is increased at earlier gestational ages and as cervical length decreases.

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Section: Resultsmentioning

confidence: 99%

Gestational age at cervical length measurement and preterm birth in twins

Ehsanipoor

Haydon

Gaffaney³

et al. 2012

Ultrasound in Obstet & Gyne

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show abstract

“…The change in CL (expressed as a percentage) was defined as the decrement in sonographic CL between the initial and follow-up measurements and was calculated using the following formula: ([CL initial -CL follow-up ]/CL initial ) × 100, where CL is the cervical length in millimeters. A short CL was defined as ≤25 mm at 20-24 weeks' gestation, which has been validated in several studies (Goldenberg et al, 1996;Imseis et al, 1997). The study was approved by the Institutional Review Board of Seoul National University Bundang Hospital (Seongnamsi, Korea), and written informed consent was obtained from all study participants prior to enrollment.…”

Section: Methodsmentioning

confidence: 99%

The Change in Cervical Length Over Time as a Predictor of Preterm Delivery in Asymptomatic Women With Twin Pregnancies Who Have a Normal Mid-Trimester Cervical Length

Park

Jeong

et al. 2012

Twin Res Hum Genet

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Aim: To determine whether or not the change in cervical length (CL) over time is valuable in predicting spontaneous preterm delivery (SPTD) in asymptomatic twin pregnancies with a normal mid-trimester CL (>25 mm). Methods: This was a prospective study including 190 consecutive asymptomatic twin gestations with a CL > 25 mm at 20-24 weeks. The women underwent an initial CL measurement at the time of routine ultrasound examination between 20 and 24 weeks' gestation, followed 4-5 weeks later by a repeat CL measurement. The primary outcome measure was SPTD at <32 completed weeks' gestation. Multicollinearity was a concern in the multivariable model since change in CL and follow-up CL were highly correlated. Results: The rate of SPTD at <32 weeks was 4.2%. Multiple logistic regression analyses demonstrated that the change in CL and the follow-up CL were significantly associated with SPTD before 32 weeks after adjusting for baseline covariate such as in vitro fertilization. The best cut-off values for the prediction of SPTD at <32 weeks' gestation were 13% for the change in CL with a sensitivity of 87.5% and a specificity of 63.2%. There was no significant difference in the area under the receiver operating characteristic curves between the change in CL and the follow-up CL. Conclusions: A greater change in CL is a good predictor of SPTD in asymptomatic twin pregnancies with a normal mid-trimester CL. However, the change in CL cannot provide data beyond the follow-up CL. In the setting of a normal mid-trimester CL, a follow-up CL measurement should be considered in asymptomatic twin pregnancies.

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“…They concluded that long cervix (44 mm) at 16-20 weeks' gestation may not provide useful clinical information to the obstetrician regarding risk of preterm delivery in twin gestations. Furthermore, a long cervix is likely only reassuring if it is maintained beyond 24 weeks' gestation as demonstrated by Imseis et al (Imseis et al, 1997).…”

Section: Progestins and Multiple Gestationsmentioning

confidence: 97%