Routine transabdominal cervical length screening in mid-pregnancy for the prevention of preterm birth: Is it good enough to use as a screening test?

IF 1.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY
Michelle K Pedretti, Jan E Dickinson, Dorota A Doherty, John P Newnham
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引用次数: 0

Abstract

Background: Preterm birth (PTB) is a major pregnancy complication. There is evidence that a short cervical length in mid-pregnancy may predict women at increased risk of PTB.

Aims: To evaluate the utility of population-based, transabdominal cervical length (TACL) measurement screening in mid-pregnancy for PTB prediction in women.

Materials and methods: A transabdominal approach was initially performed, with a transvaginal (TVCL) approach offered when the TACL was <35 mm, could not be accurately measured, or the pregnancy had risk factors for PTB. TACL was compared to the directly related TVCL, when both were performed at the same assessment. Women with risk factors of PTB were included when they had both TACL and TVCL measurements performed at the same visit.

Results: Data were provided for 9355 singleton pregnancies from 13 participating imaging centres. A transabdominal approach was used in 9006 (96.3%), including 682 (7.3%) TVCL combined with TACL. There were 349 (3.7%) women who had TVCL only. The median TACL was longer (40 mm) than the TVCL (38 mm). In 682 paired TACL and TVCL measurements, TACL <35 mm correctly identified 96.2% of pregnancies with TVCL <25 mm, compared with 65.4% of cases when using a TACL <30 mm. A TVCL <25 mm occurred in 59 (0.6%) women. A TACL <35 mm was associated with birth <37 weeks of gestation in 12.1% of women and birth <32 weeks of gestation in 3.9%.

Conclusions: Universal TACL is a feasible option for population screening of cervical length in a low-risk population, progressing to TVCL if the TACL is <35 mm or the cervix cannot be transabdominally accurately measured.

为预防早产而进行的孕中期常规经腹宫颈长度筛查:作为筛查测试是否足够好?
背景:早产(PTB)是一种主要的妊娠并发症。目的:评估基于人群的经腹宫颈长度(TACL)测量筛查在孕中期预测女性早产风险的实用性:最初采用经腹方法,当 TACL 结果为阳性时再采用经阴道(TVCL)方法:13 个参与成像中心提供了 9355 例单胎妊娠的数据。9006例(96.3%)采用了经腹方法,其中682例(7.3%)采用了TVCL结合TACL的方法。有 349 名(3.7%)妇女只采用了 TVCL。TACL 的中位数(40 毫米)长于 TVCL(38 毫米)。结论:在低风险人群中进行宫颈长度筛查时,普及 TACL 是一个可行的选择。
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来源期刊
CiteScore
3.40
自引率
11.80%
发文量
165
审稿时长
4-8 weeks
期刊介绍: The Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) is an editorially independent publication owned by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the RANZCOG Research foundation. ANZJOG aims to provide a medium for the publication of original contributions to clinical practice and/or research in all fields of obstetrics and gynaecology and related disciplines. Articles are peer reviewed by clinicians or researchers expert in the field of the submitted work. From time to time the journal will also publish printed abstracts from the RANZCOG Annual Scientific Meeting and meetings of relevant special interest groups, where the accepted abstracts have undergone the journals peer review acceptance process.
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