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Ultrasonographic cervical length screening at 20–24 weeks of gestation in twin pregnancies for prediction of spontaneous preterm birth: A 10-year Taiwanese cohort

BACKGROUND: Shortened cervical length is one of the primary predictors for spontaneous preterm deliveries in twin pregnancies. However, there is lack of consensus regarding cut-off values. Recent evidence highlights that established cut-offs for cervical length screening might not always apply acros...

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Autores principales: Olisova, Ksenia, Sao, Chih-Hsuan, Lussier, Eric C., Sung, Chan-Yu, Wang, Peng-Hui, Yeh, Chang-Ching, Chang, Tung-Yao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10553282/
https://www.ncbi.nlm.nih.gov/pubmed/37797073
http://dx.doi.org/10.1371/journal.pone.0292533
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author Olisova, Ksenia
Sao, Chih-Hsuan
Lussier, Eric C.
Sung, Chan-Yu
Wang, Peng-Hui
Yeh, Chang-Ching
Chang, Tung-Yao
author_facet Olisova, Ksenia
Sao, Chih-Hsuan
Lussier, Eric C.
Sung, Chan-Yu
Wang, Peng-Hui
Yeh, Chang-Ching
Chang, Tung-Yao
author_sort Olisova, Ksenia
collection PubMed
description BACKGROUND: Shortened cervical length is one of the primary predictors for spontaneous preterm deliveries in twin pregnancies. However, there is lack of consensus regarding cut-off values. Recent evidence highlights that established cut-offs for cervical length screening might not always apply across different populations. This study aims to present the distribution of cervical length in Taiwanese twin pregnancies and to assess its predictive value for spontaneous preterm birth during mid-trimester screening. MATERIALS AND METHODS: This retrospective analysis of cervical length screening in Taiwan evaluated 469 twin pregnancies between 20–24 weeks of gestation. Outcome data were obtained directly from the medical records of the delivery hospital. The study explored the predictive value of cervical length screening for spontaneous preterm birth and the characteristics of cervical length distribution in Taiwanese twin pregnancies. RESULTS: The average gestational age at screening was 22.7 weeks. Cervical length values displayed a non-normal distribution (p-value <0.001). The median, 5(th) and 95(th) centiles were 37.5 mm 25.1 mm, and 47.9 mm, respectively. Various cut-off values were assessed using different methods, yielding positive [negative] likelihood ratios for spontaneous preterm births between 32–37 weeks of gestational age (GA) (1.3–30.1 and [0.51–0.92]) and for very preterm births between 28–32 weeks GA (5.6–51.1 and [0.45–0.64]). CONCLUSIONS: The findings from our analysis of Taiwanese twin pregnancies uphold the moderate predictive potential of cervical length screening, consistent with prior investigations. The presented likelihood ratios for predicting preterm birth at different gestational ages equip clinicians with valuable tools to enhance their diagnostic rationale and resource utilization. By fine-tuning screening parameters according to the spontaneous preterm birth prevalence and clinical priorities of the particular population, healthcare providers can enhance patient care. Our data implies that a cervical length below 20 mm might provide an optimal balance between minimizing false negatives and managing false positives when predicting spontaneous preterm birth.
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spelling pubmed-105532822023-10-06 Ultrasonographic cervical length screening at 20–24 weeks of gestation in twin pregnancies for prediction of spontaneous preterm birth: A 10-year Taiwanese cohort Olisova, Ksenia Sao, Chih-Hsuan Lussier, Eric C. Sung, Chan-Yu Wang, Peng-Hui Yeh, Chang-Ching Chang, Tung-Yao PLoS One Research Article BACKGROUND: Shortened cervical length is one of the primary predictors for spontaneous preterm deliveries in twin pregnancies. However, there is lack of consensus regarding cut-off values. Recent evidence highlights that established cut-offs for cervical length screening might not always apply across different populations. This study aims to present the distribution of cervical length in Taiwanese twin pregnancies and to assess its predictive value for spontaneous preterm birth during mid-trimester screening. MATERIALS AND METHODS: This retrospective analysis of cervical length screening in Taiwan evaluated 469 twin pregnancies between 20–24 weeks of gestation. Outcome data were obtained directly from the medical records of the delivery hospital. The study explored the predictive value of cervical length screening for spontaneous preterm birth and the characteristics of cervical length distribution in Taiwanese twin pregnancies. RESULTS: The average gestational age at screening was 22.7 weeks. Cervical length values displayed a non-normal distribution (p-value <0.001). The median, 5(th) and 95(th) centiles were 37.5 mm 25.1 mm, and 47.9 mm, respectively. Various cut-off values were assessed using different methods, yielding positive [negative] likelihood ratios for spontaneous preterm births between 32–37 weeks of gestational age (GA) (1.3–30.1 and [0.51–0.92]) and for very preterm births between 28–32 weeks GA (5.6–51.1 and [0.45–0.64]). CONCLUSIONS: The findings from our analysis of Taiwanese twin pregnancies uphold the moderate predictive potential of cervical length screening, consistent with prior investigations. The presented likelihood ratios for predicting preterm birth at different gestational ages equip clinicians with valuable tools to enhance their diagnostic rationale and resource utilization. By fine-tuning screening parameters according to the spontaneous preterm birth prevalence and clinical priorities of the particular population, healthcare providers can enhance patient care. Our data implies that a cervical length below 20 mm might provide an optimal balance between minimizing false negatives and managing false positives when predicting spontaneous preterm birth. Public Library of Science 2023-10-05 /pmc/articles/PMC10553282/ /pubmed/37797073 http://dx.doi.org/10.1371/journal.pone.0292533 Text en © 2023 Olisova et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Olisova, Ksenia
Sao, Chih-Hsuan
Lussier, Eric C.
Sung, Chan-Yu
Wang, Peng-Hui
Yeh, Chang-Ching
Chang, Tung-Yao
Ultrasonographic cervical length screening at 20–24 weeks of gestation in twin pregnancies for prediction of spontaneous preterm birth: A 10-year Taiwanese cohort
title Ultrasonographic cervical length screening at 20–24 weeks of gestation in twin pregnancies for prediction of spontaneous preterm birth: A 10-year Taiwanese cohort
title_full Ultrasonographic cervical length screening at 20–24 weeks of gestation in twin pregnancies for prediction of spontaneous preterm birth: A 10-year Taiwanese cohort
title_fullStr Ultrasonographic cervical length screening at 20–24 weeks of gestation in twin pregnancies for prediction of spontaneous preterm birth: A 10-year Taiwanese cohort
title_full_unstemmed Ultrasonographic cervical length screening at 20–24 weeks of gestation in twin pregnancies for prediction of spontaneous preterm birth: A 10-year Taiwanese cohort
title_short Ultrasonographic cervical length screening at 20–24 weeks of gestation in twin pregnancies for prediction of spontaneous preterm birth: A 10-year Taiwanese cohort
title_sort ultrasonographic cervical length screening at 20–24 weeks of gestation in twin pregnancies for prediction of spontaneous preterm birth: a 10-year taiwanese cohort
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10553282/
https://www.ncbi.nlm.nih.gov/pubmed/37797073
http://dx.doi.org/10.1371/journal.pone.0292533
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