correlation between cervical length by transvaginal sonography at16
Transkrypt
correlation between cervical length by transvaginal sonography at16
- * Downloaded from umj.umsu.ac.ir at 4:06 IRST on Thursday March 9th 2017 1392/04/25 1392/02/14 : . . . . - : ( ( ) . ( ) ( ) : : (p<0.01). – : .(p<0.01) : : : Email: [email protected] . .( . .( ) .( - ) .( ) . ( . ) ... - . ) . (v10) Downloaded from umj.umsu.ac.ir at 4:06 IRST on Thursday March 9th 2017 - . . . . . . : .( ) : . . : .( - ) . .( ) . . . .( - ) . . spss19 ROC . .( ) Stata(11) - . . . - (% ) - .(P=0.000) ( ) (% ) .( - ) . . . ) ) - ) . . .(P=0.156) ( ) ( ( ) / ) / / ( ( ) .(P=0.568) (P=0.08). ( ) . . Downloaded from umj.umsu.ac.ir at 4:06 IRST on Thursday March 9th 2017 ) ) ) ) ( ) ( . .2.348= Error! Bookmark not defined. (P=0.155) . - ( - ) ( ) .(O.R=10) ( / ) . ) . . (P=0.245). . Cut point=34 wks :( ) - - / / / / :( ) O.R / / P-value / / / / / - / ( ... - :( ) Cut point ) ( >= ) ( >= ) ( >= ) ( >= ) ( >= ) ( >= ) ( >= ) ( >= ) ( >= ) ( >= ) ( >= ) ( >= ) ( >= ) ( >= ) Specificity Correctly Classified 0.25 0.50 Sensitivity 0.75 1.00 ( >= Sensitivity 0.00 Downloaded from umj.umsu.ac.ir at 4:06 IRST on Thursday March 9th 2017 Cutpoint 0.00 0.25 0.50 0.75 1 - Specificity Area under ROC curve = 0.8021 :ROC Iams / - - 1.00 . .( ) Naim .( ) .( ) ROC . . Downloaded from umj.umsu.ac.ir at 4:06 IRST on Thursday March 9th 2017 Berghella . / Guzman / . . - . . . . : ( ) . ( ) ) . . : . . . . . Guzman .( ) .( ) Berghella ( ) . . ... References: 1. cervix in asymptomatic pregnant women: review Botsis D, Makrakis E, PapagianniV. The value of of the literature. Ultrasound Obstet Gynecol cervical length and plasma proMMP-9 levels for 2002;19(3): 302-11. Downloaded from umj.umsu.ac.ir at 4:06 IRST on Thursday March 9th 2017 the prediction of preterm delivery in pregnant 2. 3. 5. Hauth L, Gilstrap K. Preterm Birth .Williams's Obstetrics. 22nd ed. New York: McGraw-Hill s; 108-12. 2005. P.860-2. Emily A, DeFranco DO. Improving the screening 10. MohamadJafari R, Najafian M. Transvaginal accuracy for preterm labor: is the combination of Sonography And Cervical Length Changes In fetal Normal Pregnancy. Pak J Med Sci 2009;25(2): fibronectin and cervical length in symptomatic patients a useful predictor of preterm 222-5. birth? A systematic review. Am J Obstet Gynecol 11. Gramellini S, Molina E, Berretta R, Vadora E. Transvaginalsonographic cervical Ekele B, Airede L. Cervical cerclage for length changes during normal pregnancy. J prevention of preterm delivery in women with Ultrasound Med 2002 ;21(3): 227-32. 12. Palma RS, Fonseca MM, Stein NR, Schmidt AP, 1849-53. Magalhaes JA. Relation of cervical length at 22- Ness A, Visintine J, Ricci E, Berghella V. Does 24 weeks of gestation. Brazilian J Med Biolog Res knowledge of cervical length and fetal fibronectin 2004; 5: 737-44. affect management of women with threatened 13. Iams JD, Goldenberg RL, Meis PJ, Mercer BM, preterm labor? A randomized trial. Am J Obstet Moawad A, Das A, et al. The length of the cervix Gynecol 2007;197(4): 426-7. and the risk of spontaneous preterm delivery. New Sotiriadis A, Kavvadias A, Papatheodorou England J Med 1996; 334(9): 567-72. S, Paraskevaidis E, Makrydimas G. The value of 14. Cook CM, Ellwood DA. The cervix as a predictor serial cervical length measurements for the of preterm delivery in 'at-risk' women. Ultrasound prediction of threatened preterm labour. Eur J Obstet Gyneco 2000;15(2): 109-13. Naim A, Haberman S, Burgess T, Navizedeh risk of preterm labor. Am J Obstet Gynecol 2002;186(5): 887-9. Tekesin A, Kühnert 15. Hibbard JU, Tart M, Moawad AH. Cervical length at 16-22 week gestation and risk for preterm delivery. Obstetrics Gynecol 2000;96(6): 972-8. 16. Carvalho MH, Bittar RE, BrizotMde L, Bicudo C, Zugaib M. Prediction of preterm delivery in the I, Hellmeyer L, Heller M, Schmidt S. G, Römer Evaluation of second trimester. Obstet Gynecolo 2005;105(3): 532-6. quantitative ultrasound tissue characterization of 17. Scheerer LJ, Bartolucci L. Ultra sonography in the cervix and cervical length in the prediction obstetrics and Gynecology. Ultrasound evaluation ofpremature delivery of the cervix. In: Callen PW. 4th ed. Philadelphia: for patients with spontaneous preterm labor. Am J Obstet Gynecol 2003;189(2): 532-9. 8. D, Fieni 2013; 208(3): 233-6. N, Minkoff H. Changes in cervical length and the 7. Cunningham F, Kenneth L, Steven L, Bloom J, Eur J Obstet Gynecol Reprod Biol 2006;128(1-2): Obstet Gynecol Reprod Biol 2010;148(1): 17-20. 6. 9. women presenting with threatened preterm labor. short cervix. The LANCET 2004; 363(9424): 4. - Rozenberg P, W.B. Sounders Company; 2003. 577-83. 18. Naim A, Haberma Sh, Burgess T, Navizedeh N, Gillet Transvaginalsonographic A, Ville examination of Y. the Minkoff H. Changes in cervical length and the risk ofpreterm labor. Am J Obdtet Gynecol gestations. 2002;186(5): 887-9. 2001;18(3): 204-10. Obstet Gynecol 19. Ghasemi A, Alimohammadian Sh, Davati A. 21. Berghella V, Daly SF, Tolosa JE, DiVito MM, Relationship between preterm labor and the length Chalmers R, Garg N, et al. Prediction of of the cervical canal. Payesh 2006;5(3): 177-84. pretermdelivery with transvaginal ultrasonography 20. Guzman ER, Walters C, Ananth CV, Benito CW, Downloaded from umj.umsu.ac.ir at 4:06 IRST on Thursday March 9th 2017 Ultrasound of the cervix in patients with high-risk Palermo A,Vintzileos AMcc. A comparison of pregnancies: does cerclage prevent prematurity. sonographic cervical parameters in predicting Am J Obstet Gyneco 1999;181(4): 809-15. spontaneous preterm birth in high-risk singleton The Journal of Urmia University of Medical Sciences, Vol. 24(6), August 2013 Original Article CORRELATION BETWEEN CERVICAL LENGTH BY TRANSVAGINAL SONOGRAPHY AT16-24WKS OF PREGNANCY AND PRETERM LABOR Mohamadjafari R1*,Najafian M2,Vahaby E3,Garibzadeh.S4 Downloaded from umj.umsu.ac.ir at 4:06 IRST on Thursday March 9th 2017 Received: 4 May, 2013; Accepted: 16 Jul, 2013 Abstract Background & Aims: At least two third of neonatal morbidity and mortality are due to preterm labor. Transvaginalultrasonography has an important role in diagnosis of cervical incompetency and prediction of preterm labor. The aim of this study was to determine the value of ultrasonographically measured cervical length between 16-24 weeks gestation in the prediction of spontaneous preterm delivery. Materials & Methods: A prospective cohort study examined cervical length by transvaginal ultrasonography between 16-24 weeks gestation. A total of 75 women who referred to prenatal clinic of imam Khomeini and Razi educational hospitals in Ahvaz and met inclusion criteria after measuring cervical length (c l) by transvaginal ultrasonography (TVS). They included two groups (36 cases with c l =26-30 m and 40 cases with cl=30-35mm. Then they followed until delivery. Results: The incidence of preterm labor in c l=26-30 mm was 38% and in group with c l=30-35 mm was 50%. Respectively, in the multivariate analysis, age, parity, job, education, and cl. There was a statistically significant relation between cl and preterm birth. (p<0.01) Conclusion: Mechanical and chemical factors can effect on the cl and cause preterm labor. A short cervix seen on 16-24 weeks gestation was a strong predictor of preterm birth. Keywords: Preterm birth, Cervical length, Transvaginal ultrasonography Address: Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Tel: 00989166178041 Email: [email protected] SOURCE: URMIA MED J 2013: 24(6): 448 ISSN: 1027-3727 1 Associate Professor Obstetrics & Gynecology, Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 2 Associate Professor Obstetrics & Gynecology, Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 3 Resident of Gynecology and Obstetrics, Department of ob & gyn, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 4 Ph.D Student of Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran