Benito Vielba Marta, De Bonrostro Torralba Carlos, Álvarez Sarrado Leticia, Tajada Duaso Mauricio, Campillos Maza José Manuel, Castán Mateo Sergio
Department of Obstetrics and Gynecology, Hospital Universitario Miguel Servet, Paseo Isabel la Católica 1-3, 50009, Zaragoza, Spain.
Department of Obstetrics, Hospital Universitario Miguel Servet, Paseo Isabel la Católica, 1-3, 50009, Zaragoza, Spain.
Eur J Obstet Gynecol Reprod Biol. 2021 May;260:131-136. doi: 10.1016/j.ejogrb.2021.03.025. Epub 2021 Mar 20.
To compare the performance of uterocervical angle (UCA) and cervical length (CL) measurement at 20 weeks of pregnancy for prediction of spontaneous preterm birth (sPTB) in twin pregnancies.
We conducted a retrospective cohort study of 424 twin pregnancies who delivered in our center from October 2014 to December 2018 and who underwent transvaginal ultrasound between 19-22 weeks to measure CL during routine second trimester scan. Recorded ultrasound images of CL were reassessed to evaluate UCA. Medical and obstetric data were also collected for statistical analysis.
A total of 424 women were included. The rates of sPTB rate below 28, 32 and 34 weeks of gestation were 2.8 %, 5.4 % and 10.4 %, respectively. ROC curves showed a better area under the curve (AUC) for UCA at all gestational ages compared with CL (AUC for sPTB <28 weeks 0.902 (p < 0.001) vs 0.620 (p 0.175); AUC for sPTB <32 weeks 0.740 (p 0.001) vs 0.620 (p 0.058); AUC for sPTB <34 weeks 0.676 (p 0.001) vs 0.632 (p 0.047). UCA > 120 degrees was significantly associated with sPTB <28 weeks (p < 0.001; OR 39.17; CI 4.81-319.23; NPV, 99.65 %), <32 weeks (OR 4.23; p 0.002) and <34 weeks of gestation (OR 2.66; p 0.01).
In our study, an UCA > 120 degrees allowed to identify those women with twin pregnancies at risk of sPTB and performed better than CL measurement.
比较孕20周时子宫颈角度（UCA）和宫颈长度（CL）测量对双胎妊娠自发性早产（sPTB）的预测性能。
我们对2014年10月至2018年12月在本中心分娩的424例双胎妊娠进行了一项回顾性队列研究，这些孕妇在孕19 - 22周期间接受了经阴道超声检查，以在常规孕中期扫描时测量CL。对记录的CL超声图像进行重新评估以评估UCA。还收集了医学和产科数据进行统计分析。
共纳入424名女性。孕28周、32周和34周以下的sPTB发生率分别为2.8%、5.4%和10.4%。ROC曲线显示，在所有孕周，UCA的曲线下面积（AUC）均优于CL（孕28周以下sPTB的AUC为0.902（p < 0.001），而CL为0.620（p 0.175）；孕32周以下sPTB的AUC为0.740（p 0.001），而CL为0.620（p 0.058）；孕34周以下sPTB的AUC为0.676（p 0.001），而CL为0.632（p 0.047））。UCA > 120度与孕28周以下（p < 0.001；OR 39.17；CI 4.81 - 319.23；NPV，99.65%）、32周以下（OR 4.23；p 0.002）和孕34周以下（OR 2.66；p 0.01）的sPTB显著相关。
在我们的研究中，UCA > 120度能够识别有sPTB风险的双胎妊娠女性，并且其表现优于CL测量。
