A predictive model of short cervix at 20-24 weeks using first-trimester cervical length measurement and maternal history

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Souka, A. P.
Papastefanou, I.
Michalitsi, V.
Papadopoulos, G. K.
Kassanos, D.

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peer-reviewed

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Prenat Diagn

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OBJECTIVES: To develop a model for the prediction of short cervix ( </= 15 mm) at 20-24 weeks by combining maternal history and transvaginal ultrasonographic measurement of cervical length at 11-14 weeks. To explore the value of an additional ultrasound examination of the cervix at about 17 weeks. METHODS: Longitudinal prospective study in 800 unselected pregnant women presenting for first-trimester ultrasound assessment by nuchal translucency and serum biochemistry. Cervical length was evaluated transvaginally between 11 weeks and 13 weeks and 6 days (cx1), at 16-19 weeks (cx2) and 20-24 weeks (cx3). Backward multiple logistic regression analysis with cx3 </= 15 mm as the dependent variable was used to identify the predictors of a short cervix at 20-24 weeks. RESULTS: Cx1 and history of preterm delivery were significant independent contributors of a short cervix at 20-24 weeks [area under the curve (AUC 0.808, p < 0.001, Model) 1]. Furthermore, the cx1/cx2 ratio was a significant independent predictor of a short cervix at 20-24 weeks (odds ratio = 58.325 p = 0.012). The addition of the cx1/cx2 ratio improved the model (AUC = 0.878, p < 0.001, Model 2). CONCLUSIONS: A short cervix at 20-24 weeks can be predicted at the 11-14 weeks scan. The addition of a cervical measurement at about 17 weeks can improve the prediction model.

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Adolescent, Adult, *Cervical Length Measurement, Cervix Uteri/*ultrasonography, Feasibility Studies, Female, Humans, Middle Aged, Models, Biological, Pregnancy, Pregnancy Complications/*ultrasonography, Pregnancy Trimester, First, Prospective Studies, Uterine Cervical Diseases/*ultrasonography, Young Adult

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http://www.ncbi.nlm.nih.gov/pubmed/21268041
http://onlinelibrary.wiley.com/store/10.1002/pd.2683/asset/2683_ftp.pdf?v=1&t=h0utqihy&s=b58b32824669ce7c7811b50c7bbfa915885e122c

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en

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Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής

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