Novel transvaginal ultrasound (TVU) markers have been proposed to improve spontaneous preterm birth (sPTB) prediction. Preliminary results of the cervical consistency index (CCI), uterocervical angle (UCA), and cervical texture (CTx) have been promising in singletons. However, in twin pregnancies, the results have been inconsistent. In this prospective cohort study of asymptomatic twin pregnancies assessed between 18+0-22+0 weeks, we evaluated TVU derived cervical length (CL), CCI, UCA, and the CTx to predict sPTB < 34+0 weeks. All iatrogenic PTB were excluded. In the final cohort of 63 pregnancies, the sPTB rate < 34+0 was 16.3%. The CCI, UCA, and CTx, including the CL was significantly different in the sPTB < 34+0 weeks group. The best area under the receiver operating characteristic curve (AUC) for sPTB < 34+0 weeks was achieved by the CCI 0.82 (95%CI, 0.72-0.93), followed by the UCA with AUC 0.72 (95%CI, 0.57-0.87). A logistic regression model incorporating parity, chorionicity, CCI, and UCA resulted in an AUC of 0.91 with a sensitivity of 55.3% and specificity of 88.1% for predicting sPTB < 34+0. The CCI performed better than other TVU markers to predict sPTB < 34+0 in twin gestations, and the best diagnostic accuracy was achieved by a combination of parity, chorionicity, CCI, and UCA.

译文

已经提出了新型的经阴道超声 (TVU) 标记物来改善自发早产 (sPTB) 的预测。宫颈一致性指数 (CCI),子宫角 (UCA) 和宫颈纹理 (CTx) 的初步结果在单例中是有希望的。然而,在双胎妊娠中,结果并不一致。在这项在18 0-22 0周之间评估的无症状双胎妊娠的前瞻性队列研究中,我们评估了TVU衍生的宫颈长度 (CL),CCI,UCA和CTx来预测sPTB <34 0周。排除所有医源性PTB。在63例妊娠的最终队列中,sPTB率 <34 + 0为16.3%。在sPTB <34 0周组中,CCI,UCA和CTx (包括CL) 有显着差异。通过CCI 0.82 (95% CI,0.72-0.93) 实现了sPTB <34 + 0周的接收器工作特性曲线 (AUC) 下的最佳面积,其次是具有AUC 0.72的UCA (95% CI,0.57-0.87)。结合了奇偶性,绒毛膜性,CCI和UCA的逻辑回归模型导致0.91的AUC,其55.3% 的敏感性和88.1% 的特异性预测sPTB <34 0。CCI在预测双胎中sPTB <34 0方面的表现优于其他TVU标记,并且通过奇偶性,绒毛膜性,CCI和UCA的组合获得了最佳的诊断准确性。

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