Jordan C Knight1, Emily Tenbrink1, Mitchell Onslow1, Avinash S Patil2,3. 1. Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana. 2. Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana. 3. Center for Personalized Obstetric Medicine, Valley Perinatal Services, Phoenix, Arizona.
Abstract
OBJECTIVE: Twin pregnancies are associated with an increased risk of spontaneous preterm birth. Our objective was to compare the performance of uterocervical angle to cervical length as predictors of spontaneous preterm birth in this population. METHODS: We conducted a retrospective cohort study of twin gestations at a single center from May 2008 to 2016 who received a transvaginal ultrasound for the evaluation of the cervix between 16 0/7 and 23 0/7 weeks. The primary outcome was prediction of preterm birth <28 and <32 weeks by uterocervical angle and cervical length. RESULTS: Among 259 women with twin gestation, the mean gestational age at birth was 34.83 ± 3.48 weeks. Receiver operator characteristic curves demonstrated optimal prediction of spontaneous preterm birth prior to 32 weeks at a uterocervical angle >110° (80% sensitivity, 82% specificity) [odds ratio (OR), 15.7 (95% confidence interval (CI), 7.2-34.4)] versus cervical length <20 mm (53% sensitivity, 85% specificity; p < 0.001, OR, 6.4 [95% CI, 2.3-17.8]) and similarly, prior to 28 weeks at a uterocervical angle >114° (OR, 24.3 [95% CI, 6.7-88.5]) compared with cervical length <20 mm (OR, 11.4 [95% CI, 3.5-36.7]). CONCLUSION: Uterocervical angles >110° performed better than cervical length for the prediction of spontaneous preterm birth in twin gestations. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
OBJECTIVE: Twin pregnancies are associated with an increased risk of spontaneous preterm birth. Our objective was to compare the performance of uterocervical angle to cervical length as predictors of spontaneous preterm birth in this population. METHODS: We conducted a retrospective cohort study of twin gestations at a single center from May 2008 to 2016 who received a transvaginal ultrasound for the evaluation of the cervix between 16 0/7 and 23 0/7 weeks. The primary outcome was prediction of preterm birth <28 and <32 weeks by uterocervical angle and cervical length. RESULTS: Among 259 women with twin gestation, the mean gestational age at birth was 34.83 ± 3.48 weeks. Receiver operator characteristic curves demonstrated optimal prediction of spontaneous preterm birth prior to 32 weeks at a uterocervical angle >110° (80% sensitivity, 82% specificity) [odds ratio (OR), 15.7 (95% confidence interval (CI), 7.2-34.4)] versus cervical length <20 mm (53% sensitivity, 85% specificity; p < 0.001, OR, 6.4 [95% CI, 2.3-17.8]) and similarly, prior to 28 weeks at a uterocervical angle >114° (OR, 24.3 [95% CI, 6.7-88.5]) compared with cervical length <20 mm (OR, 11.4 [95% CI, 3.5-36.7]). CONCLUSION: Uterocervical angles >110° performed better than cervical length for the prediction of spontaneous preterm birth in twin gestations. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Ilknur Col Madendag; Mefkure Eraslan Sahin; Yusuf Madendag; Erdem Sahin; Mustafa Bertan Demir; Fatma Ozdemir; Gokhan Acmaz; Iptisam Ipek Muderris Journal: J Int Med Res Date: 2019-12-25 Impact factor: 1.671