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Value of serial cervical length measurement in prediction of spontaneous preterm birth in post-conization pregnancy without short mid-trimester cervix.
Scientific Reports ( IF 3.8 ) Pub Date : 2018-Oct-17 , DOI: 10.1038/s41598-018-33537-1 Liang Wang
Scientific Reports ( IF 3.8 ) Pub Date : 2018-Oct-17 , DOI: 10.1038/s41598-018-33537-1 Liang Wang
Serial cervical length (CL) measurement in mid-trimester is recommended in post-conization pregnancy to estimate the risk of spontaneous preterm birth (SPTB). A short mid-trimester cervix (CL < 25 mm) has been considered as a strong predictor for SPTB. However, the low incidence of short cervix limits the utility of mid-trimester CL measurement in prediction of SPTB. A great proportion of women who develop SPTB don't have a short mid-trimester cervix. Therefore, this study was aimed to investigate the additional value of serial CL measurement in predicting SPTB in addition to detecting short cervix alone. A total of 613 post-conization pregnant women who did not have short mid-trimester cervix between January 2004 and January 2014 were included in this study. Serial CL measurements were taken by transvaginal ultrasound at three timepoints (A: 13 + 0-15 + 6 weeks, B: 16 + 0-18 + 6 weeks, and C: 20 + 0-22 + 6 weeks). Eight parameters were analyzed for predicting SPTB, including CL measurements at different timepoints (CLA, CLB, CLC), the maximum and minimum CL measurements (CLMAX, CLMIN), and the percentage change in CL measurement between different timepoints (%ΔCLAB, %ΔCLBC, %ΔCLAC). After univariate and multivariate analysis, CLMAX and %ΔCLAC were independent variables in predicting SPTB. Lower CLMAX (OR [95%CI]: 0.92 [0.90-0.93]) and higher %ΔCLAC (OR [95%CI]: 1.05 [1.01-1.09]) were related to an increasing risk of SPTB. In conclusion, our study for the first time in literature reported the value of serial CL measurement in prediction of SPTB in post-conization pregnancy without short mid-trimester cervix. In the subpopulation of pregnant women who did not have short mid-trimester cervix, CLMAX and %ΔCLAC were of value in predicting SPTB, which warranted further investigations.
中文翻译：
无子宫颈中期妊娠的连续宫颈长度测量对产后妊娠自发性早产的预测价值。
建议在分娩后妊娠中进行连续中期宫颈长度（CL）测量，以估计自发性早产（SPTB）的风险。早孕中期子宫颈短（CL <25 mm）被认为是SPTB的重要预测指标。然而，子宫颈短发的低发率限制了妊娠中期CL测量在预测SPTB中的实用性。罹患SPTB的女性中，大部分子宫颈的中期妊娠期较短。因此，本研究旨在研究串行CL测量在预测仅SPPT之外，还可以预测SPTB的附加价值。2004年1月至2014年1月期间，共有613例妊娠中期子宫颈短的孕妇被纳入本研究。通过阴道超声在三个时间点（A：13 + 0-15 + 6周，B：16 + 0-18 + 6周，C：20 + 0-22 + 6周）进行连续CL测量。分析了八个参数以预测SPTB，包括在不同时间点的CL测量（CL甲，CL乙，CL Ç），最大和最小CL测量（CL MAX，CL MIN），并且在不同的时间点（％ΔCL之间CL测量的百分比变化AB，ΔCL％BC，％ΔCL AC）。经过单因素和多因素分析，CL MAX和％ΔCL AC均预测SPTB独立变量。下CL MAX（OR [95％CI]：0.92 [0.90-0.93]）和更高％ΔCL AC（OR [95％CI]：1.05 [1.01-1.09]）与SPTB风险增加有关。总而言之，我们的研究首次在文献中报道了连续CL测量对没有妊娠中期子宫颈的产后妊娠预测SPTB的价值。在谁没有短孕中期宫颈妊娠妇女的亚群，CL MAX和％ΔCL AC预测SPTB，这值得进一步调查是有价值的。
更新日期：2018-10-17
中文翻译：
无子宫颈中期妊娠的连续宫颈长度测量对产后妊娠自发性早产的预测价值。
建议在分娩后妊娠中进行连续中期宫颈长度（CL）测量，以估计自发性早产（SPTB）的风险。早孕中期子宫颈短（CL <25 mm）被认为是SPTB的重要预测指标。然而，子宫颈短发的低发率限制了妊娠中期CL测量在预测SPTB中的实用性。罹患SPTB的女性中，大部分子宫颈的中期妊娠期较短。因此，本研究旨在研究串行CL测量在预测仅SPPT之外，还可以预测SPTB的附加价值。2004年1月至2014年1月期间，共有613例妊娠中期子宫颈短的孕妇被纳入本研究。通过阴道超声在三个时间点（A：13 + 0-15 + 6周，B：16 + 0-18 + 6周，C：20 + 0-22 + 6周）进行连续CL测量。分析了八个参数以预测SPTB，包括在不同时间点的CL测量（CL甲，CL乙，CL Ç），最大和最小CL测量（CL MAX，CL MIN），并且在不同的时间点（％ΔCL之间CL测量的百分比变化AB，ΔCL％BC，％ΔCL AC）。经过单因素和多因素分析，CL MAX和％ΔCL AC均预测SPTB独立变量。下CL MAX（OR [95％CI]：0.92 [0.90-0.93]）和更高％ΔCL AC（OR [95％CI]：1.05 [1.01-1.09]）与SPTB风险增加有关。总而言之，我们的研究首次在文献中报道了连续CL测量对没有妊娠中期子宫颈的产后妊娠预测SPTB的价值。在谁没有短孕中期宫颈妊娠妇女的亚群，CL MAX和％ΔCL AC预测SPTB，这值得进一步调查是有价值的。
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