Mid-trimester residual cervical length and the risk of preterm birth in pregnancies after abdominal radical trachelectomy: A retrospective analysis

Yoshifumi Kasuga, Kei Miyakoshi, Hiroshi Nishio, Y. Akiba, T. Otani, M. Fukutake, Satoru Ikenoue, Daigo Ochiai, T. Matsumoto, Kyoko Tanaka, K. Minegishi, N. Kuji, R. Roberts, Daisuke Aoki, Mamoru Tanaka

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3 Citations (Scopus)

Abstract

Objective: To investigate the association between mid-trimester residual cervical length (CL) and the risk of preterm birth in pregnancies after abdominal radical trachelectomy (RT). Design: Retrospective cohort study. Setting: University hospital. Population: A total of 33 deliveries after 22 weeks' gestation in 30 women who underwent abdominal RT including prophylactic cervical cerclage and perinatal care between January 2002 and May 2016. Methods: The association between mid-trimester residual CL (the distance between the cerclage and the external cervical os) and gestational age at delivery was investigated. Receiver-operating characteristics (ROC) curve analysis was performed to estimate the optimal cut-off values of the mid-trimester residual CL for the prediction of preterm birth. Main outcome measures: Preterm birth before 34 weeks' gestation. Results: Mid-trimester residual CL showed a significant correlation with gestational age at delivery (r = 0.36, P < 0.05). There was a significant difference in residual CL between women who did and those who did not give birth before 34 weeks (P < 0.05). Mid-trimester residual CL < 13 mm was a good predictor of birth before 34 weeks, with a sensitivity of 67%, specificity of 75%, positive predictive value of 55% and negative predictive value of 86% (area under ROC curve, 0.75). Conclusions: Mid-trimester residual CL is significantly correlated with gestational age at delivery. Residual CL assessment could be used to reassure physicians and women that there is only a small chance of preterm birth in pregnancies after abdominal RT. Tweetable abstract: Mid-trimester residual cervical length is a good predictor of preterm birth after radical trachelectomy.

Original languageEnglish
JournalBJOG: An International Journal of Obstetrics and Gynaecology
DOIs
Publication statusAccepted/In press - 2017

Fingerprint

Abdominal Pregnancy
Premature Birth
Cervical Cerclage
Gestational Age
ROC Curve
Parturition
Women Physicians
Perinatal Care
Pregnancy
Cohort Studies
Retrospective Studies
Outcome Assessment (Health Care)
Trachelectomy
Sensitivity and Specificity
Population

Keywords

  • Abdominal radical trachelectomy
  • Cervix
  • Length
  • Preterm birth
  • Transvaginal

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

@article{d7f593a6c3c54dba992921a235c7afe0,
title = "Mid-trimester residual cervical length and the risk of preterm birth in pregnancies after abdominal radical trachelectomy: A retrospective analysis",
abstract = "Objective: To investigate the association between mid-trimester residual cervical length (CL) and the risk of preterm birth in pregnancies after abdominal radical trachelectomy (RT). Design: Retrospective cohort study. Setting: University hospital. Population: A total of 33 deliveries after 22 weeks' gestation in 30 women who underwent abdominal RT including prophylactic cervical cerclage and perinatal care between January 2002 and May 2016. Methods: The association between mid-trimester residual CL (the distance between the cerclage and the external cervical os) and gestational age at delivery was investigated. Receiver-operating characteristics (ROC) curve analysis was performed to estimate the optimal cut-off values of the mid-trimester residual CL for the prediction of preterm birth. Main outcome measures: Preterm birth before 34 weeks' gestation. Results: Mid-trimester residual CL showed a significant correlation with gestational age at delivery (r = 0.36, P < 0.05). There was a significant difference in residual CL between women who did and those who did not give birth before 34 weeks (P < 0.05). Mid-trimester residual CL < 13 mm was a good predictor of birth before 34 weeks, with a sensitivity of 67{\%}, specificity of 75{\%}, positive predictive value of 55{\%} and negative predictive value of 86{\%} (area under ROC curve, 0.75). Conclusions: Mid-trimester residual CL is significantly correlated with gestational age at delivery. Residual CL assessment could be used to reassure physicians and women that there is only a small chance of preterm birth in pregnancies after abdominal RT. Tweetable abstract: Mid-trimester residual cervical length is a good predictor of preterm birth after radical trachelectomy.",
keywords = "Abdominal radical trachelectomy, Cervix, Length, Preterm birth, Transvaginal",
author = "Yoshifumi Kasuga and Kei Miyakoshi and Hiroshi Nishio and Y. Akiba and T. Otani and M. Fukutake and Satoru Ikenoue and Daigo Ochiai and T. Matsumoto and Kyoko Tanaka and K. Minegishi and N. Kuji and R. Roberts and Daisuke Aoki and Mamoru Tanaka",
year = "2017",
doi = "10.1111/1471-0528.14688",
language = "English",
journal = "BJOG: An International Journal of Obstetrics and Gynaecology",
issn = "1470-0328",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Mid-trimester residual cervical length and the risk of preterm birth in pregnancies after abdominal radical trachelectomy

T2 - A retrospective analysis

AU - Kasuga, Yoshifumi

AU - Miyakoshi, Kei

AU - Nishio, Hiroshi

AU - Akiba, Y.

AU - Otani, T.

AU - Fukutake, M.

AU - Ikenoue, Satoru

AU - Ochiai, Daigo

AU - Matsumoto, T.

AU - Tanaka, Kyoko

AU - Minegishi, K.

AU - Kuji, N.

AU - Roberts, R.

AU - Aoki, Daisuke

AU - Tanaka, Mamoru

PY - 2017

Y1 - 2017

N2 - Objective: To investigate the association between mid-trimester residual cervical length (CL) and the risk of preterm birth in pregnancies after abdominal radical trachelectomy (RT). Design: Retrospective cohort study. Setting: University hospital. Population: A total of 33 deliveries after 22 weeks' gestation in 30 women who underwent abdominal RT including prophylactic cervical cerclage and perinatal care between January 2002 and May 2016. Methods: The association between mid-trimester residual CL (the distance between the cerclage and the external cervical os) and gestational age at delivery was investigated. Receiver-operating characteristics (ROC) curve analysis was performed to estimate the optimal cut-off values of the mid-trimester residual CL for the prediction of preterm birth. Main outcome measures: Preterm birth before 34 weeks' gestation. Results: Mid-trimester residual CL showed a significant correlation with gestational age at delivery (r = 0.36, P < 0.05). There was a significant difference in residual CL between women who did and those who did not give birth before 34 weeks (P < 0.05). Mid-trimester residual CL < 13 mm was a good predictor of birth before 34 weeks, with a sensitivity of 67%, specificity of 75%, positive predictive value of 55% and negative predictive value of 86% (area under ROC curve, 0.75). Conclusions: Mid-trimester residual CL is significantly correlated with gestational age at delivery. Residual CL assessment could be used to reassure physicians and women that there is only a small chance of preterm birth in pregnancies after abdominal RT. Tweetable abstract: Mid-trimester residual cervical length is a good predictor of preterm birth after radical trachelectomy.

AB - Objective: To investigate the association between mid-trimester residual cervical length (CL) and the risk of preterm birth in pregnancies after abdominal radical trachelectomy (RT). Design: Retrospective cohort study. Setting: University hospital. Population: A total of 33 deliveries after 22 weeks' gestation in 30 women who underwent abdominal RT including prophylactic cervical cerclage and perinatal care between January 2002 and May 2016. Methods: The association between mid-trimester residual CL (the distance between the cerclage and the external cervical os) and gestational age at delivery was investigated. Receiver-operating characteristics (ROC) curve analysis was performed to estimate the optimal cut-off values of the mid-trimester residual CL for the prediction of preterm birth. Main outcome measures: Preterm birth before 34 weeks' gestation. Results: Mid-trimester residual CL showed a significant correlation with gestational age at delivery (r = 0.36, P < 0.05). There was a significant difference in residual CL between women who did and those who did not give birth before 34 weeks (P < 0.05). Mid-trimester residual CL < 13 mm was a good predictor of birth before 34 weeks, with a sensitivity of 67%, specificity of 75%, positive predictive value of 55% and negative predictive value of 86% (area under ROC curve, 0.75). Conclusions: Mid-trimester residual CL is significantly correlated with gestational age at delivery. Residual CL assessment could be used to reassure physicians and women that there is only a small chance of preterm birth in pregnancies after abdominal RT. Tweetable abstract: Mid-trimester residual cervical length is a good predictor of preterm birth after radical trachelectomy.

KW - Abdominal radical trachelectomy

KW - Cervix

KW - Length

KW - Preterm birth

KW - Transvaginal

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U2 - 10.1111/1471-0528.14688

DO - 10.1111/1471-0528.14688

M3 - Article

C2 - 28418597

AN - SCOPUS:85019886672

JO - BJOG: An International Journal of Obstetrics and Gynaecology

JF - BJOG: An International Journal of Obstetrics and Gynaecology

SN - 1470-0328

ER -