The predictive value of sequential cervical length screening in singleton pregnancies after cerclage: a retrospective cohort study

BMC Pregnancy and Childbirth

Research Article

Rudolf Seemann¹  Max-Paul Winter²  Regina Promberger³  Sophie Pils⁴  Wolfgang Eppel⁴  Johannes Ott⁴ 

[1] Department of Craniomaxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria;Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria;Department of Obstetrics and Gynecology, Krankenhaus Hietzing, Vienna, Austria;Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria;

关键词: Cerclage;    Cervical length;    Preterm delivery;    Delivery;    Cervical insufficiency;   

DOI  :  10.1186/s12884-016-0866-3

 received in 2015-05-08, accepted in 2016-04-07,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThere are few valid predictors for preterm delivery after cerclage. Experience with a screening program that included four sequential cervical length measurements in singleton pregnancies after cerclage is reviewed.MethodsIn this retrospective cohort study, 88 singleton pregnancies after cerclage were included. Cervical length (CL) measurements were performed perioperatively and at weeks 16 + 0, 18 + 0, 20 + 0, and 22 + 0 by transvaginal ultrasound. Predictive factors for early preterm delivery included patient characteristics, obstetric history and CL measurements and were analyzed separately for women with ultrasound-indicated cerclage and those with history-indicated cerclage. Women with emergency cerclage were excluded.ResultsIn women with delivery <35 weeks, CL declined from the 16 + 0 to the 22 + 0 weeks of gestation (p = 0.009). In univariate analysis, all CL measurements were predictive for delivery <35 weeks in women who underwent ultrasound-indicated cerclage and in women who received a history-indicated cerclage, whereas in multivariate analysis only CL three to six days after cerclage remained significant (odds ratio 0.85, 95 % CI 0.73–0.98). In women with ultrasound-indicated cerclage, optimized cut-off was ≤20 mm (specificity 83.8 %, sensitivity 84.2 %).ConclusionsCL measured three to six days after cerclage placement provides the best information about the risk for delivery <35 weeks.

【 授权许可】

CC BY   
© Pils et al. 2016