A predictive model of short cervix at 20-24 weeks using first-trimester cervical length measurement and maternal history

作者：Souka A P^*; Papastefanou I; Michalitsi V; Papadopoulos G K; Kassanos D

来源：Prenatal Diagnosis, 2011, 31(2): 202-206.

DOI：10.1002/pd.2683

• short cervix
• first-trimester cervical length
• preterm delivery
• transvaginal ultrasound
• cervical incompetence

Objectives To develop a model for the prediction of short cervix (<= 15 mm) at 20-24 weeks by combining maternal history and transvaginal ultrasonographic measurement of cervical length at 11-14 weeks. To explore the value of an additional ultrasound examination of the cervix at about 17 weeks.
Methods Longitudinal prospective study in 800 unselected pregnant women presenting for first-trimester ultrasound assessment by nuchal translucency and serum biochemistry. Cervical length was evaluated transvaginally between 11 weeks and 13 weeks and 6 days (cx1), at 16-19 weeks (cx2) and 20-24 weeks (cx3). Backward multiple logistic regression analysis with cx3 <= 15 mm as the dependent variable was used to identify the predictors of a short cervix at 20-24 weeks.
Results Cx1 and history of preterm delivery were significant independent contributors of a short cervix at 20-24 weeks [area under the curve (AUC 0.808, p < 0.001, Model) 1]. Furthermore, the cx1/cx2 ratio was a significant independent predictor of a short cervix at 20-24 weeks (odds ratio = 58.325 p = 0.012). The addition of the cx1/cx2 ratio improved the model (AUC = 0.878, p < 0.001, Model 2).
Conclusions A short cervix at 20-24 weeks can be predicted at the 11-14 weeks scan. The addition of a cervical measurement at about 17 weeks can improve the prediction model.

• 出版日期2011-2