Sequential cervical length screening in pregnancies after loop excision of the transformation zone conisation: a retrospective analysis
Objective To review our experience with a screening programme that included four sequential cervical length (CL) measurements from 16 to 22 weeks of gestation. Design Historical cohort study. Setting Tertiary‐care centre in a university hospital. Population There were 312 singleton pregnancies in 32...
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| Veröffentlicht in: | BJOG : an international journal of obstetrics and gynaecology 2014-03, Vol.121 (4), p.457-463 |
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| creator | Pils, S Eppel, W Seemann, R Natter, C Ott, J |
| description | Objective
To review our experience with a screening programme that included four sequential cervical length (CL) measurements from 16 to 22 weeks of gestation.
Design
Historical cohort study.
Setting
Tertiary‐care centre in a university hospital.
Population
There were 312 singleton pregnancies in 321 women with a previous large loop excision of the transformation zone (LLETZ), and 62 pregnancies after a second‐trimester miscarriage in a previous pregnancy.
Methods
The CL measurements were performed by transvaginal ultrasound at 16, 18, 20, and 22 completed weeks of gestation.
Main outcome measures
Early preterm delivery before 34 completed weeks of gestation.
Results
Early preterm delivery was found in 7.4%. The CL at 16 completed weeks of gestation was smaller in the LLETZ group (36 mm, interquartile range 30–40 mm) compared with the control group (38 mm, interquartile range 32–42 mm; P = 0.040). For the analysis of risk factors for early preterm delivery after LLETZ, only cases with a complete data set were included (n = 145). In a multivariate analysis, two parameters remained significantly predictive, with CL at 16 completed weeks of gestation being the most significant measure (P |
| doi_str_mv | 10.1111/1471-0528.12390 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1891868957</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3220790581</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5110-f2256cc80518d8e921e84e3efc08e72f52883ec262a160075e31e3a76f2fcb523</originalsourceid><addsrcrecordid>eNqFkT1PHDEQhq0IFD6SOl1kiSbNwthe73rpAIWPCIkiSW0ZMz6M9uyN7SO5_IH8bXx3hIKGaTwzeuaVXr-EfGJwyGodsbZnDUiuDhkXA7wjuy-brXUPDQiudshezg8ArOMg3pMd3rJWSQW75N93_LXAULwZqcX06G1tRgyzck-zTYjBhxn1gU4JZ8EE6zFT4womOsY4UfxjffYx0OhouUdakgnZxTQ3ZbX9GwNSG4PP6_mYGpqwpJgntMU_IjXBjMvs8wey7cyY8ePzu09-nn_9cXbZXN9cXJ2dXDdWMgaN41x21iqQTN0pHDhD1aJAZ0Fhz131rQRa3nHDOoBeomAoTN857uyt5GKffNnoTilW47nouc8Wx9EEjIusmRqY6tQg-7dRCdANXPRtRQ9eoQ9xkaq1SrWDknLo1VCpow1l6wfkhE5Pyc9NWmoGehWnXoWnV-HpdZz14vOz7uJ2jncv_P_8KiA3wG8_4vItPX367WYj_AQu6ar7</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1498559789</pqid></control><display><type>article</type><title>Sequential cervical length screening in pregnancies after loop excision of the transformation zone conisation: a retrospective analysis</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Pils, S ; Eppel, W ; Seemann, R ; Natter, C ; Ott, J</creator><creatorcontrib>Pils, S ; Eppel, W ; Seemann, R ; Natter, C ; Ott, J</creatorcontrib><description>Objective
To review our experience with a screening programme that included four sequential cervical length (CL) measurements from 16 to 22 weeks of gestation.
Design
Historical cohort study.
Setting
Tertiary‐care centre in a university hospital.
Population
There were 312 singleton pregnancies in 321 women with a previous large loop excision of the transformation zone (LLETZ), and 62 pregnancies after a second‐trimester miscarriage in a previous pregnancy.
Methods
The CL measurements were performed by transvaginal ultrasound at 16, 18, 20, and 22 completed weeks of gestation.
Main outcome measures
Early preterm delivery before 34 completed weeks of gestation.
Results
Early preterm delivery was found in 7.4%. The CL at 16 completed weeks of gestation was smaller in the LLETZ group (36 mm, interquartile range 30–40 mm) compared with the control group (38 mm, interquartile range 32–42 mm; P = 0.040). For the analysis of risk factors for early preterm delivery after LLETZ, only cases with a complete data set were included (n = 145). In a multivariate analysis, two parameters remained significantly predictive, with CL at 16 completed weeks of gestation being the most significant measure (P < 0.001, OR 0.90, 95% CI 0.83–0.98), followed by conception using IVF treatment (P = 0.031, OR 0.64, 95% CI 1.54–34.80).
Conclusions
Even as early as 16 weeks of gestation, women with early preterm delivery reveal a significantly lower CL than those without. Dynamics in the CL do not add to this information.</description><identifier>ISSN: 1470-0328</identifier><identifier>EISSN: 1471-0528</identifier><identifier>DOI: 10.1111/1471-0528.12390</identifier><identifier>PMID: 24148580</identifier><identifier>CODEN: BIOGFQ</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Abortion, Spontaneous - diagnostic imaging ; Adolescent ; Adult ; Cervical Intraepithelial Neoplasia - surgery ; Cervical length ; Cervical Length Measurement ; Cervix Uteri - diagnostic imaging ; Cervix Uteri - surgery ; conisation ; Conization - methods ; Female ; Fetal Membranes, Premature Rupture - diagnostic imaging ; Fetal Membranes, Premature Rupture - etiology ; Gestational Age ; Humans ; loop excision of the transformation zone ; Medical screening ; Middle Aged ; Obstetric Labor, Premature - diagnostic imaging ; Obstetric Labor, Premature - etiology ; Obstetrics ; Odds Ratio ; Postoperative Complications - diagnostic imaging ; prediction ; Predictive Value of Tests ; Pregnancy ; Pregnancy Trimester, Second ; Premature Birth - diagnostic imaging ; Premature Birth - etiology ; preterm delivery ; Retrospective Studies ; risk factor ; Risk Factors ; Sensitivity and Specificity ; Uterine Cervical Neoplasms - surgery ; Young Adult</subject><ispartof>BJOG : an international journal of obstetrics and gynaecology, 2014-03, Vol.121 (4), p.457-463</ispartof><rights>2013 RCOG</rights><rights>2013 RCOG.</rights><rights>Copyright © 2014 Royal College of Obstetricians and Gynaecologists</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5110-f2256cc80518d8e921e84e3efc08e72f52883ec262a160075e31e3a76f2fcb523</citedby><cites>FETCH-LOGICAL-c5110-f2256cc80518d8e921e84e3efc08e72f52883ec262a160075e31e3a76f2fcb523</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2F1471-0528.12390$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2F1471-0528.12390$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,27907,27908,45557,45558</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24148580$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pils, S</creatorcontrib><creatorcontrib>Eppel, W</creatorcontrib><creatorcontrib>Seemann, R</creatorcontrib><creatorcontrib>Natter, C</creatorcontrib><creatorcontrib>Ott, J</creatorcontrib><title>Sequential cervical length screening in pregnancies after loop excision of the transformation zone conisation: a retrospective analysis</title><title>BJOG : an international journal of obstetrics and gynaecology</title><addtitle>BJOG</addtitle><description>Objective
To review our experience with a screening programme that included four sequential cervical length (CL) measurements from 16 to 22 weeks of gestation.
Design
Historical cohort study.
Setting
Tertiary‐care centre in a university hospital.
Population
There were 312 singleton pregnancies in 321 women with a previous large loop excision of the transformation zone (LLETZ), and 62 pregnancies after a second‐trimester miscarriage in a previous pregnancy.
Methods
The CL measurements were performed by transvaginal ultrasound at 16, 18, 20, and 22 completed weeks of gestation.
Main outcome measures
Early preterm delivery before 34 completed weeks of gestation.
Results
Early preterm delivery was found in 7.4%. The CL at 16 completed weeks of gestation was smaller in the LLETZ group (36 mm, interquartile range 30–40 mm) compared with the control group (38 mm, interquartile range 32–42 mm; P = 0.040). For the analysis of risk factors for early preterm delivery after LLETZ, only cases with a complete data set were included (n = 145). In a multivariate analysis, two parameters remained significantly predictive, with CL at 16 completed weeks of gestation being the most significant measure (P < 0.001, OR 0.90, 95% CI 0.83–0.98), followed by conception using IVF treatment (P = 0.031, OR 0.64, 95% CI 1.54–34.80).
Conclusions
Even as early as 16 weeks of gestation, women with early preterm delivery reveal a significantly lower CL than those without. Dynamics in the CL do not add to this information.</description><subject>Abortion, Spontaneous - diagnostic imaging</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Cervical Intraepithelial Neoplasia - surgery</subject><subject>Cervical length</subject><subject>Cervical Length Measurement</subject><subject>Cervix Uteri - diagnostic imaging</subject><subject>Cervix Uteri - surgery</subject><subject>conisation</subject><subject>Conization - methods</subject><subject>Female</subject><subject>Fetal Membranes, Premature Rupture - diagnostic imaging</subject><subject>Fetal Membranes, Premature Rupture - etiology</subject><subject>Gestational Age</subject><subject>Humans</subject><subject>loop excision of the transformation zone</subject><subject>Medical screening</subject><subject>Middle Aged</subject><subject>Obstetric Labor, Premature - diagnostic imaging</subject><subject>Obstetric Labor, Premature - etiology</subject><subject>Obstetrics</subject><subject>Odds Ratio</subject><subject>Postoperative Complications - diagnostic imaging</subject><subject>prediction</subject><subject>Predictive Value of Tests</subject><subject>Pregnancy</subject><subject>Pregnancy Trimester, Second</subject><subject>Premature Birth - diagnostic imaging</subject><subject>Premature Birth - etiology</subject><subject>preterm delivery</subject><subject>Retrospective Studies</subject><subject>risk factor</subject><subject>Risk Factors</subject><subject>Sensitivity and Specificity</subject><subject>Uterine Cervical Neoplasms - surgery</subject><subject>Young Adult</subject><issn>1470-0328</issn><issn>1471-0528</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkT1PHDEQhq0IFD6SOl1kiSbNwthe73rpAIWPCIkiSW0ZMz6M9uyN7SO5_IH8bXx3hIKGaTwzeuaVXr-EfGJwyGodsbZnDUiuDhkXA7wjuy-brXUPDQiudshezg8ArOMg3pMd3rJWSQW75N93_LXAULwZqcX06G1tRgyzck-zTYjBhxn1gU4JZ8EE6zFT4womOsY4UfxjffYx0OhouUdakgnZxTQ3ZbX9GwNSG4PP6_mYGpqwpJgntMU_IjXBjMvs8wey7cyY8ePzu09-nn_9cXbZXN9cXJ2dXDdWMgaN41x21iqQTN0pHDhD1aJAZ0Fhz131rQRa3nHDOoBeomAoTN857uyt5GKffNnoTilW47nouc8Wx9EEjIusmRqY6tQg-7dRCdANXPRtRQ9eoQ9xkaq1SrWDknLo1VCpow1l6wfkhE5Pyc9NWmoGehWnXoWnV-HpdZz14vOz7uJ2jncv_P_8KiA3wG8_4vItPX367WYj_AQu6ar7</recordid><startdate>201403</startdate><enddate>201403</enddate><creator>Pils, S</creator><creator>Eppel, W</creator><creator>Seemann, R</creator><creator>Natter, C</creator><creator>Ott, J</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201403</creationdate><title>Sequential cervical length screening in pregnancies after loop excision of the transformation zone conisation: a retrospective analysis</title><author>Pils, S ; Eppel, W ; Seemann, R ; Natter, C ; Ott, J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5110-f2256cc80518d8e921e84e3efc08e72f52883ec262a160075e31e3a76f2fcb523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Abortion, Spontaneous - diagnostic imaging</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Cervical Intraepithelial Neoplasia - surgery</topic><topic>Cervical length</topic><topic>Cervical Length Measurement</topic><topic>Cervix Uteri - diagnostic imaging</topic><topic>Cervix Uteri - surgery</topic><topic>conisation</topic><topic>Conization - methods</topic><topic>Female</topic><topic>Fetal Membranes, Premature Rupture - diagnostic imaging</topic><topic>Fetal Membranes, Premature Rupture - etiology</topic><topic>Gestational Age</topic><topic>Humans</topic><topic>loop excision of the transformation zone</topic><topic>Medical screening</topic><topic>Middle Aged</topic><topic>Obstetric Labor, Premature - diagnostic imaging</topic><topic>Obstetric Labor, Premature - etiology</topic><topic>Obstetrics</topic><topic>Odds Ratio</topic><topic>Postoperative Complications - diagnostic imaging</topic><topic>prediction</topic><topic>Predictive Value of Tests</topic><topic>Pregnancy</topic><topic>Pregnancy Trimester, Second</topic><topic>Premature Birth - diagnostic imaging</topic><topic>Premature Birth - etiology</topic><topic>preterm delivery</topic><topic>Retrospective Studies</topic><topic>risk factor</topic><topic>Risk Factors</topic><topic>Sensitivity and Specificity</topic><topic>Uterine Cervical Neoplasms - surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pils, S</creatorcontrib><creatorcontrib>Eppel, W</creatorcontrib><creatorcontrib>Seemann, R</creatorcontrib><creatorcontrib>Natter, C</creatorcontrib><creatorcontrib>Ott, J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pils, S</au><au>Eppel, W</au><au>Seemann, R</au><au>Natter, C</au><au>Ott, J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sequential cervical length screening in pregnancies after loop excision of the transformation zone conisation: a retrospective analysis</atitle><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle><addtitle>BJOG</addtitle><date>2014-03</date><risdate>2014</risdate><volume>121</volume><issue>4</issue><spage>457</spage><epage>463</epage><pages>457-463</pages><issn>1470-0328</issn><eissn>1471-0528</eissn><coden>BIOGFQ</coden><abstract>Objective
To review our experience with a screening programme that included four sequential cervical length (CL) measurements from 16 to 22 weeks of gestation.
Design
Historical cohort study.
Setting
Tertiary‐care centre in a university hospital.
Population
There were 312 singleton pregnancies in 321 women with a previous large loop excision of the transformation zone (LLETZ), and 62 pregnancies after a second‐trimester miscarriage in a previous pregnancy.
Methods
The CL measurements were performed by transvaginal ultrasound at 16, 18, 20, and 22 completed weeks of gestation.
Main outcome measures
Early preterm delivery before 34 completed weeks of gestation.
Results
Early preterm delivery was found in 7.4%. The CL at 16 completed weeks of gestation was smaller in the LLETZ group (36 mm, interquartile range 30–40 mm) compared with the control group (38 mm, interquartile range 32–42 mm; P = 0.040). For the analysis of risk factors for early preterm delivery after LLETZ, only cases with a complete data set were included (n = 145). In a multivariate analysis, two parameters remained significantly predictive, with CL at 16 completed weeks of gestation being the most significant measure (P < 0.001, OR 0.90, 95% CI 0.83–0.98), followed by conception using IVF treatment (P = 0.031, OR 0.64, 95% CI 1.54–34.80).
Conclusions
Even as early as 16 weeks of gestation, women with early preterm delivery reveal a significantly lower CL than those without. Dynamics in the CL do not add to this information.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>24148580</pmid><doi>10.1111/1471-0528.12390</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1470-0328 |
| ispartof | BJOG : an international journal of obstetrics and gynaecology, 2014-03, Vol.121 (4), p.457-463 |
| issn | 1470-0328 1471-0528 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1891868957 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Abortion, Spontaneous - diagnostic imaging Adolescent Adult Cervical Intraepithelial Neoplasia - surgery Cervical length Cervical Length Measurement Cervix Uteri - diagnostic imaging Cervix Uteri - surgery conisation Conization - methods Female Fetal Membranes, Premature Rupture - diagnostic imaging Fetal Membranes, Premature Rupture - etiology Gestational Age Humans loop excision of the transformation zone Medical screening Middle Aged Obstetric Labor, Premature - diagnostic imaging Obstetric Labor, Premature - etiology Obstetrics Odds Ratio Postoperative Complications - diagnostic imaging prediction Predictive Value of Tests Pregnancy Pregnancy Trimester, Second Premature Birth - diagnostic imaging Premature Birth - etiology preterm delivery Retrospective Studies risk factor Risk Factors Sensitivity and Specificity Uterine Cervical Neoplasms - surgery Young Adult |
| title | Sequential cervical length screening in pregnancies after loop excision of the transformation zone conisation: a retrospective analysis |
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