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- Title
Mid-trimester residual cervical length and the risk of preterm birth in pregnancies after abdominal radical trachelectomy: a retrospective analysis.
- Authors
Kasuga, Y; Miyakoshi, K; Nishio, H; Akiba, Y; Otani, T; Fukutake, M; Ikenoue, S; Ochiai, D; Matsumoto, T; Tanaka, K; Minegishi, K; Kuji, N; Roberts, R; Aoki, D; Tanaka, M
- Abstract
<bold>Objective: </bold>To investigate the association between mid-trimester residual cervical length (CL) and the risk of preterm birth in pregnancies after abdominal radical trachelectomy (RT).<bold>Design: </bold>Retrospective cohort study.<bold>Setting: </bold>University hospital.<bold>Population: </bold>A total of 33 deliveries after 22 weeks' gestation in 30 women who underwent abdominal RT including prophylactic cervical cerclage and perinatal care between January 2002 and May 2016.<bold>Methods: </bold>The association between mid-trimester residual CL (the distance between the cerclage and the external cervical os) and gestational age at delivery was investigated. Receiver-operating characteristics (ROC) curve analysis was performed to estimate the optimal cut-off values of the mid-trimester residual CL for the prediction of preterm birth.<bold>Main Outcome Measures: </bold>Preterm birth before 34 weeks' gestation.<bold>Results: </bold>Mid-trimester residual CL showed a significant correlation with gestational age at delivery (r = 0.36, P < 0.05). There was a significant difference in residual CL between women who did and those who did not give birth before 34 weeks (P < 0.05). Mid-trimester residual CL < 13 mm was a good predictor of birth before 34 weeks, with a sensitivity of 67%, specificity of 75%, positive predictive value of 55% and negative predictive value of 86% (area under ROC curve, 0.75).<bold>Conclusions: </bold>Mid-trimester residual CL is significantly correlated with gestational age at delivery. Residual CL assessment could be used to reassure physicians and women that there is only a small chance of preterm birth in pregnancies after abdominal RT.<bold>Tweetable Abstract: </bold>Mid-trimester residual cervical length is a good predictor of preterm birth after radical trachelectomy.
- Subjects
JAPAN; RISK factors in premature labor; TRACHELECTOMY; CERVIX uteri; PREMATURE labor; LABOR complications (Obstetrics); FETAL ultrasonic imaging; PREMATURE infants; PREGNANCY complications; SECOND trimester of pregnancy; CERVIX uteri tumors; TREATMENT effectiveness; PREDICTIVE tests; RETROSPECTIVE studies; RECEIVER operating characteristic curves; CERVICAL cerclage
- Publication
BJOG: An International Journal of Obstetrics & Gynaecology, 2017, Vol 124, Issue 11, p1729
- ISSN
1470-0328
- Publication type
journal article
- DOI
10.1111/1471-0528.14688