Is sonographic assessment of cervical length better than digital examination in screening for preterm delivery in a low‐risk population?

Matijević, Ratko; Grgić, Ozren; Vasilj, Oliver

doi:10.1080/00016340600935722

Cited by 37 publications

(22 citation statements)

References 25 publications

(53 reference statements)

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“…The distribution of CL values obtained in our study was similar to the previously published reports [14][15][16][17][18] . Comparing the accuracy for prediction of early PTL, the 5 th centile of CL (< 26 mm) in our study and the 5 th centile of CL (< 22mm) in the study of Iams et al; our results showed better PPV (46.6% versus 26%) and better sensitivity (87.5% versus 30%) 15 .…”

Section: Discussionsupporting

confidence: 81%

“…With significant difference found on conventional LR and LR weighted by prevalence calculation (35.1 and 2.7) we conclude that CL measurement has its place in the assessment of low risk pregnant women in population based PTL screening programs. This is already confirmed by some of our previously published reports 18,19 . Unfortunately, this significance is not so good in the assessment of low risk population for early PTL.…”

Section: Discussionsupporting

confidence: 81%

“…It is our belief that such difference is results of relatively low number of women included in our study but it might be also influenced by the CL cut of point value used in order to diagnose cervical insufficiency. The results of diagnostic accuracy obtained in this study are even better compared to some our previously published reports 18,19 . We believe that this difference represents our personal learning curve improvement in CL assessment and screening for PTL.…”

Section: Discussionsupporting

confidence: 37%

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Vaginal pH versus cervical length in the mid‐trimester as screening predictors of preterm labor in a low‐risk population

Matijević

Grgić

Knežević

2010

Intl J Gynecology & Obste

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Methods: Prospective cohort study of 316 low-risk pregnant women. Vaginal pH was measured using test gloves for measuring the vaginal acidity, while CL was measured using transvaginal ultrasound. The cut off value for vaginal pH used was 5.0 (95 th centile for our population) whereas shortened CL was defined as < 26 mm (5 th centile for our population).Results: Elevated vaginal pH was found in 4.4% whereas shortened CL was found in 2.8%. The incidence of PTL (< 37 weeks) was 7.2%, and early PTL (< 34 weeks) was 3.4%. Shortened CL is significantly related to PTL (LR weighted by prevalence 2.7, 95% CI 1.1-6.7) but is not to early PTL (LR weighted by prevalence 0.8, 95% CI 0.4-1.8). Elevated vaginal pH is better predictor of PTL (LR weighted by prevalence 3.7, 95% CI 1.3-10.4) and early PTL (LR weighted by prevalence 1.7, 95% CI 1.1-3.1). Conclusion:Elevated vaginal pH has better accuracy in comparison with shortened CL regarding the prediction of early PTL in low risk pregnant women.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 37%

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Vaginal pH versus cervical length in the mid‐trimester as screening predictors of preterm labor in a low‐risk population

Matijević

Grgić

Knežević

2010

Intl J Gynecology & Obste

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“…17–21,23–27,30,61,62 Additionally, Moroz and Simhan 221 reported a significant association between cervical shortening and maternal systemic inflammation (determined by C-reactive protein; r 2 =.44, P =.001) in women with a sonographic short cervix (≤25 mm) diagnosed between 21 and 28 weeks of gestation. However, this association was not observed in patients without a short cervix.…”

Section: | Discussionmentioning

confidence: 99%

The cytokine network in women with an asymptomatic short cervix and the risk of preterm delivery

Tarca

Fitzgerald

Chaemsaithong

et al. 2017

American J Rep Immunol

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ProblemTo characterize the amniotic fluid (AF) inflammatory-related protein (IRP) network in patients with a sonographic short cervix (SCx) and to determine its relation to early preterm delivery (ePTD).Method of studyA retrospective cohort study included women with a SCx (≤25 mm; n=223) who had amniocentesis and were classified according to gestational age (GA) at diagnosis and delivery (ePTD <32 weeks of gestation).Results(i) In women with a SCx ≤ 22 1/7 weeks, the concentration of most IRPs increased as the cervix shortened; those with ePTD had a higher rate of increase in MIP-1α, MCP-1, and IL-6 concentrations than those delivering later; and (ii) the concentration of most IRPs and the correlation between several IRP pairs were higher in the ePTD group than for those delivering later.ConclusionWomen with a SCx at 16–22 1/7 weeks have a unique AF cytokine network that correlates with cervical length at diagnosis and GA at delivery. This network may aid in predicting ePTD.

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“…По мнению большинства ис-следователей [3][4][5], пальпаторная диагностика ИЦН яв-ляется субъективной и обладает высокой частотой ложно-положительных результатов -до 40%. В настоящее время влагалищное определение длины шейки матки сменяется ее измерением с помощью трансвагинальной эхографии [6]. Однако, по данным В.М.…”

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Isthmicocervical insufficiency: Diagnosis and correction

Astrakhantseva¹,

Breusenko²,

Lebedev³

et al. 2016

Ross. vestn. akush.-ginekol.

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1 Кафедра акушерства и гинекологии педиатрического факультета (зав. -акад. РАН, д.м.н., проф. Г.М. Савельева) ГБОУ ВПО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия; 2 ГБУЗ «Центр планирования семьи и репродукции» ДЗМ, Москва (глав. врач -О.А. Латышкевич) Цель исследования -выявление факторов риска развития истмико-цервикальной недостаточности (ИЦН), определение возможности своевременной ее диагностики и коррекции во II триместре беременности. Материал и методы. В про-спективное исследование включены 257 пациенток с одноплодной беременностью во II триместре (в сроки 13-27 нед беременности). Среди них 93 пациентки были госпитализированы в гинекологическое отделение с диагнозом: истмико-цервикальная недостаточность. Критериями включения в основную группу (76 пациенток) являлись симптомы ИЦН, установленные по данным трансвагинальной эхографии и мануального исследования, которые чаще выявлялись в сроки беременности 16-22 нед. У 17 наблюдаемых не было выявлено укорочения шейки матки при ультразвуковом исследо-вании -они были исключены из анализа. У 164 беременных течение беременности было физиологическим, без изме-нений состояния шейки матки (контрольная группа). Степень выраженности ИЦН оценивалась на основании балльной шкалы. Коррекция ИЦН проведена 70 (92,1%) пациенткам из 76 наблюдаемых основной группы: цервикальный серкляж (по методу McDonald) осуществлен 41 (58,6%) пациентке до 22 нед гестации, акушерский пессарий установлен 29 (41,4%) беременным после 22 нед беременности. В том числе последовательное использование 2 методов (хирургической коррек-ции и применения акушерского пессария) выполнено у 3 (4,3%) наблюдаемых. Результаты. Коррекция ИЦН была эффек-тивной у 66 (94,3%) из 70 пациенток, подвергшихся лечению ИЦН; в том числе у 1 из 2 наблюдаемых -при длине шейки матки 10 мм. Своевременные роды произошли у 62 (88,6%) пациенток и у 4 (5,7%) роды были в сроке гестации 34-36 нед. Преждевременно родили 8 (11,5%) из 70 пациенток. После проведения цервикального серкляжа своевременно родили 35 (85,4%). Преждевременные роды произошли у 6 (14,6%; отношение шансов -ОШ -0,10; 95% доверительный интервал -ДИ -0,02-0,94): у 2 -до 32 нед, у 4 в 34-36 нед. После использования акушерского пессария своевременные роды произошли у 27 (93,1%), преждевременные роды -у 2 (6,9%), в сроке до 28 нед (OШ 0,14; 95% ДИ 0,014-1,23). Заклю-чение. Состояние шейки матки необходимо оценивать у всех беременных, в том числе в группе риска преждевременного прерывания беременности, начиная с 16 нед беременности. Своевременное выявление ИЦН и адекватная ее коррекция эффективны, так как способствуют пролонгированию беременности до срока более 34 нед у 94% пациенток.Авторы информируют об отсутствии конфликта интересов. Objective -to identify risk factors for isthmicocervical insufficiency (ICI) and to determine the possibilities of its timely diagnosis and correction in the second trimester of pregnancy. Subject and methods. The prospective study enrolled 257 patients with mono...

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Is sonographic assessment of cervical length better than digital examination in screening for preterm delivery in a low‐risk population?

Cited by 37 publications

References 25 publications

Vaginal pH versus cervical length in the mid‐trimester as screening predictors of preterm labor in a low‐risk population

Vaginal pH versus cervical length in the mid‐trimester as screening predictors of preterm labor in a low‐risk population

The cytokine network in women with an asymptomatic short cervix and the risk of preterm delivery

Isthmicocervical insufficiency: Diagnosis and correction

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