Role of transvaginal sonographic cervical length in predicting spontaneous preterm delivery in triplet pregnancies with therapeutic cerclage
Poggi, S.H.; Ghidini, A.; Landy, H.J.; McLaren, R.; Oyelese, Y.; Alvarez, M.; Pezzullo, J.C.; Collea, J.V.
Journal of Reproductive Medicine 48(10): 785-788
2003
ISSN/ISBN: 0024-7758 PMID: 14619645 Document Number: 560582
OBJECTIVE: To assess the role of transvaginal sonographic cervical length in predicting spontaneous preterm delivery at <32 weeks in patients with both triplet pregnancy and therapeutic cerclage. STUDY DESIGN: The maternal records of all triplet pregnancies with therapeutic cerclage and sonographic cervical length before and after cerclage were reviewed (n=17). Each of these triplet gestations was matched with 2 triplet pregnancies without cerclage based on cervical length after cerclage (+-0.5 cm) and gestational age (+-3 weeks). Statistical analysis included Fisher's exact test or chi2 analysis, one-way analysis of variance, logistic regression analysis and receiver operating characteristic curve analysis. RESULTS: Cerclage was placed at a gestational age of 19.0+-3.1 weeks (mean+-SD) and increased cervical length from 2.0+-0.7 cm to 3.1+-1.4 cm (P<.05). The rate of spontaneous preterm delivery at <32 weeks was higher among cases than controls (7/17 vs. 4/27, P=.08). Logistic regression analysis demonstrated that only postcerclage cervical length was predictive of spontaneons preterm delivery at <32 weeks, with a cervical length of 3.3 cm the optimal predictor. CONCLUSION: In women with triplets and therapeutic cerclage, the only significant predictor of spontaneous preterm delivery at <32 weeks is cervical length after cerclage placement.