How to identify twins at low risk of spontaneous preterm delivery
(2005) In Ultrasound in Obstetrics & Gynecology 26(2). p.138-144- Abstract
- Objective The aim of this study was to evaluate transvaginal sonograpbic assessment of cervical length at 23 weeks as a screening test for spontaneous preterm delivery in order to define a cut-off value that could be used to select twin pregnancies at low risk of spontaneous preterm delivery. Methods In a prospective multicenter study of 383 twin pregnancies included before 14 + 6 weeks a cervical scan with measurement of the cervical length was performed at 23 weeks' gestation. The results were blinded for the clinicians if the cervical length was >= 15 mm. The rates of spontaneous delivery at different cut-off levels of cervical length were determined. Results Eighty-nine percent of the twins had dichorionic placentation and 58% were... (More)
- Objective The aim of this study was to evaluate transvaginal sonograpbic assessment of cervical length at 23 weeks as a screening test for spontaneous preterm delivery in order to define a cut-off value that could be used to select twin pregnancies at low risk of spontaneous preterm delivery. Methods In a prospective multicenter study of 383 twin pregnancies included before 14 + 6 weeks a cervical scan with measurement of the cervical length was performed at 23 weeks' gestation. The results were blinded for the clinicians if the cervical length was >= 15 mm. The rates of spontaneous delivery at different cut-off levels of cervical length were determined. Results Eighty-nine percent of the twins had dichorionic placentation and 58% were conceived after assisted reproduction. The rate of spontaneous preterm delivery was 2.3% (1.5% for dichorionic (DC) and 9.1% for (MC) monochorionic twins) before 28 weeks and 18.5% (17.1% for DC and 29.5% for MC twins) before 35 weeks. The screen-positive rate was 5% for a cervical length <= 20, 7-8% at <= 25, 16-17% at <= 30 and 34-48% at <= 35mm depending on chorionicity. The false-negative rate (1 - negative predictive value) ranged from 1.2% at 28 weeks to 18.6% at 35 weeks for all twins. Receiver-operating characteristics curves showed that the sensitivity increased with declining gestation I age with cut-off levels of highest accuracy at 21 mm for 28 weeks and 29 mm for 33 weeks. Conclusions Cervical length measurement at 23 weeks of gestation is a good screening test for predicting twins at low risk of preterm and very preterm delivery, especially in DC twins. The present results suggest that a cut-off of 25 mm should be recommended. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/226515
- author
- organization
- publishing date
- 2005
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- screening, preterm delivery, cervical assessment, multiple pregnancy, twin pregnancy, ultrasonography
- in
- Ultrasound in Obstetrics & Gynecology
- volume
- 26
- issue
- 2
- pages
- 138 - 144
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- wos:000231276700007
- pmid:16038015
- scopus:27544474214
- ISSN
- 1469-0705
- DOI
- 10.1002/uog.1938
- language
- English
- LU publication?
- yes
- id
- 05f9e070-cea8-42d2-a53d-e3920ceb48f4 (old id 226515)
- date added to LUP
- 2016-04-01 15:35:30
- date last changed
- 2022-01-28 06:05:39
@article{05f9e070-cea8-42d2-a53d-e3920ceb48f4, abstract = {{Objective The aim of this study was to evaluate transvaginal sonograpbic assessment of cervical length at 23 weeks as a screening test for spontaneous preterm delivery in order to define a cut-off value that could be used to select twin pregnancies at low risk of spontaneous preterm delivery. Methods In a prospective multicenter study of 383 twin pregnancies included before 14 + 6 weeks a cervical scan with measurement of the cervical length was performed at 23 weeks' gestation. The results were blinded for the clinicians if the cervical length was >= 15 mm. The rates of spontaneous delivery at different cut-off levels of cervical length were determined. Results Eighty-nine percent of the twins had dichorionic placentation and 58% were conceived after assisted reproduction. The rate of spontaneous preterm delivery was 2.3% (1.5% for dichorionic (DC) and 9.1% for (MC) monochorionic twins) before 28 weeks and 18.5% (17.1% for DC and 29.5% for MC twins) before 35 weeks. The screen-positive rate was 5% for a cervical length <= 20, 7-8% at <= 25, 16-17% at <= 30 and 34-48% at <= 35mm depending on chorionicity. The false-negative rate (1 - negative predictive value) ranged from 1.2% at 28 weeks to 18.6% at 35 weeks for all twins. Receiver-operating characteristics curves showed that the sensitivity increased with declining gestation I age with cut-off levels of highest accuracy at 21 mm for 28 weeks and 29 mm for 33 weeks. Conclusions Cervical length measurement at 23 weeks of gestation is a good screening test for predicting twins at low risk of preterm and very preterm delivery, especially in DC twins. The present results suggest that a cut-off of 25 mm should be recommended.}}, author = {{Sperling, L and Kiil, C and Larsen, LU and Qvist, I and Bach, D and Wojdemann, K and Bladh, A and Nikkilä, Annamari and Jörgensen, C and Skajaa, K and Bang, J and Tabor, A}}, issn = {{1469-0705}}, keywords = {{screening; preterm delivery; cervical assessment; multiple pregnancy; twin pregnancy; ultrasonography}}, language = {{eng}}, number = {{2}}, pages = {{138--144}}, publisher = {{John Wiley & Sons Inc.}}, series = {{Ultrasound in Obstetrics & Gynecology}}, title = {{How to identify twins at low risk of spontaneous preterm delivery}}, url = {{http://dx.doi.org/10.1002/uog.1938}}, doi = {{10.1002/uog.1938}}, volume = {{26}}, year = {{2005}}, }