Prediction of patient‐specific risk of early preterm delivery using maternal history and sonographic measurement of cervical length: a population‐based prospective study

Abstract

ABSTRACT

Transvaginal cervical length measurement for prediction of preterm birth in women with threatened preterm labor: a meta‐analysis

“…In contrast to asymptomatic women, for whom screening measurement of the cervical length in the midtrimester can accurately detect many who will subsequently deliver preterm 8 , and for whom prophylactic administration of progesterone may effectively prevent extreme prematurity in many of them 9 , both detection and prevention of true preterm birth appear to be problematic in women who present with symptoms of preterm labor.…”

“…Prediction and prevention of preterm birth have come a long way in asymptomatic women; measurement of the length of the uterine cervix can achieve a 55% sensitivity for a false positive rate of 10% 8 and administration of progesterone in women with a short (< 15 mm) cervix can decrease the likelihood of preterm birth at less than 34 weeks' gestation by 45% 9 .…”

Risk Prediction for Adverse Pregnancy Outcomes in a Medicaid Population

“…15 Even models derived from large samples have failed to provide high predictive performance. 13,14,17,18 More recent efforts have focused on biomarkers such as pregnancy-associated plasma protein A, fetal fibronectin, and placental growth factor to augment the predictive capacity of demographic and clinical risk factors; however, this body of research has not yet yielded a clear approach for implementation in clinical practice. [19][20][21][22] As with prior studies, important risk factors in our model included race and obstetric history.…”

“…[13][14][15] More recently, risk models including cervical length as well as various biomarkers have shown promise in increasing prognostic performance. [16][17][18][19][20][21][22] However, this research has not yet yielded a risk assessment tool for use in clinical practice; moreover, the majority of these prediction models have been derived using a general population, which may overinflate their ability to discriminate risk within an a priori at-risk population of Medicaid recipients.…”

Ultrasound Screening in Low-risk Obstetrical Population: Effect on Perinatal Outcome

“…It is a widely accepted and well-standardized method which can be easily performed in both high and low-risk patients as a screening test for preterm delivery. 24 It has a high negative predictive value in a high-risk population but because the low prevalence of preterm delivery, the sensitivity and positive predictive value are low in a lowrisk population. Nevertheless it is a better method than obstetric history in predicting preterm labor and when used together the detection rate is almost 60%.…”