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How to identify twi...
How to identify twins at low risk of spontaneous preterm delivery
- Article/chapterEnglish2005
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LIBRIS-ID:oai:lup.lub.lu.se:05f9e070-cea8-42d2-a53d-e3920ceb48f4
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https://lup.lub.lu.se/record/226515URI
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https://doi.org/10.1002/uog.1938DOI
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Language:English
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Summary in:English
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Objective The aim of this study was to evaluate transvaginal sonograpbic assessment of cervical length at 23 weeks as a screening test for spontaneous preterm delivery in order to define a cut-off value that could be used to select twin pregnancies at low risk of spontaneous preterm delivery. Methods In a prospective multicenter study of 383 twin pregnancies included before 14 + 6 weeks a cervical scan with measurement of the cervical length was performed at 23 weeks' gestation. The results were blinded for the clinicians if the cervical length was >= 15 mm. The rates of spontaneous delivery at different cut-off levels of cervical length were determined. Results Eighty-nine percent of the twins had dichorionic placentation and 58% were conceived after assisted reproduction. The rate of spontaneous preterm delivery was 2.3% (1.5% for dichorionic (DC) and 9.1% for (MC) monochorionic twins) before 28 weeks and 18.5% (17.1% for DC and 29.5% for MC twins) before 35 weeks. The screen-positive rate was 5% for a cervical length <= 20, 7-8% at <= 25, 16-17% at <= 30 and 34-48% at <= 35mm depending on chorionicity. The false-negative rate (1 - negative predictive value) ranged from 1.2% at 28 weeks to 18.6% at 35 weeks for all twins. Receiver-operating characteristics curves showed that the sensitivity increased with declining gestation I age with cut-off levels of highest accuracy at 21 mm for 28 weeks and 29 mm for 33 weeks. Conclusions Cervical length measurement at 23 weeks of gestation is a good screening test for predicting twins at low risk of preterm and very preterm delivery, especially in DC twins. The present results suggest that a cut-off of 25 mm should be recommended.
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Kiil, C
(author)
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Larsen, LU
(author)
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Qvist, I
(author)
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Bach, D
(author)
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Wojdemann, K
(author)
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Bladh, A
(author)
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Nikkilä, AnnamariLund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)gyn-ani
(author)
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Jörgensen, C
(author)
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Skajaa, K
(author)
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Bang, J
(author)
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Tabor, A
(author)
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Obstetrik och gynekologi, LundSektion V
(creator_code:org_t)
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In:Ultrasound in Obstetrics & Gynecology: Wiley26:2, s. 138-1441469-07050960-7692
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Sperling, L
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Kiil, C
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Larsen, LU
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Qvist, I
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Bach, D
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Wojdemann, K
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Bladh, A
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Nikkilä, Annamar ...
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Jörgensen, C
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Skajaa, K
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Bang, J
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Tabor, A
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Ultrasound in Ob ...
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Lund University