Cervical Length Measurement for the Prediction of Preterm Birth in Symptomatic Women with a Twin Pregnancy: A Systematic Review and Meta-Analysis
نویسندگان
چکیده
Objective. The aim of this study was to assess whether cervical length measurement (CL) could predict preterm birth (PTB) in symptomatic women with a twin pregnancy. Methods. We searched MEDLINE and EMBASE to identify studies investigating the accuracy of CL measurement in predicting PTB in symptomatic women with a twin pregnancy. We extracted data to construct two-by-two tables and used bivariate meta-analysis to generate point estimates of sensitivity and specificity. Results. Five studies (N = 226) were included. Variation in definition of PTB and cut-off points for CL was strong. One study investigated delivery within seven days, demonstrating a sensitivity of 1.0 (95% CI: 0.83-1.0) and a specificity of 0.31 (95% CI 0.2-0.43) for a CL cutoff at 25 mm. Three studies reported on predicting PTB < 37 weeks at a CL cutoff of 30 mm, with sROC point estimates of 0.76 (95% CI: 0.66 to 0.84) and 0.37 (95% CI: 0.21 to 0.56) for sensitivity and specificity, respectively. For preterm birth <34 weeks, no pooled estimates could be estimated since only 2 studies with large heterogeneity were identified. Conclusions. There is limited evidence on the accuracy of cervical length measurement testing the prediction of preterm birth in symptomatic women with a twin pregnancy, especially on the most important outcome, that is, delivery within 7 days.
منابع مشابه
Re: Predictive value of cervical length in women with twin pregnancy presenting with threatened preterm labor. N. Melamed, L. Hiersch, R. Gabbay-Benziv, R. Bardin, I. Meizner, A. Wiznitzer and Y. Yogev. Ultrasound Obstet Gynecol 2015; 46: 73-81.
This paper represents another important piece of the puzzle that is sonographic cervical length measurement for the prediction of preterm birth. Cervical length is now well established as a predictor of preterm birth in both twin and singleton populations in asymptomatic women, a fact that has grown in clinical relevance, with data suggesting that perhaps in both populations, but certainly in s...
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ورودعنوان ژورنال:
دوره 2013 شماره
صفحات -
تاریخ انتشار 2013