Comparison of transvaginal sonography in recumbent and standing maternal positions to predict spontaneous preterm birth in singleton and twin pregnancies

Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology
Birgit ArabinJim van Eyck

Abstract

To evaluate whether serial transvaginal sonographic examination of the cervix with the woman in a standing position improves the prediction of spontaneous preterm birth (SPB) compared with the conventional posture. For both a recumbent and upright maternal position, the inter- and intraobserver agreement of cervical length (CL) measurement was calculated. In 363 pregnancies at risk for SPB, we determined prospectively CL and funnel width (FW) including differences between the positions and between longitudinal measurements from 15 weeks onwards. Multivariate logistic regression analysis, contingency tables and receiver-operating characteristics (ROC) curves were used. Data were stratified according to singleton or twin pregnancy, maternal position, gestational age at examination and different cut-off values to predict SPB < 36 weeks. The interobserver variability in each position was similar, with an interclass correlation coefficient (95% CI) of 0.952 (0.811-0.984) in the recumbent and 0.942 (0.837-0.978) in the upright maternal position. After exclusion of pregnancies with iatrogenic preterm birth, 15/138 (11%) singletons and 29/153 (19%) twin pairs were born at <36 weeks. The incidence of funneling was greater in an upright ...Continue Reading

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Citations

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