Predicting preterm delivery in asymptomatic patients with prior preterm delivery by measurement of cervical length and phosphorylated insulin-like growth factor-binding protein-1.
Ultrasound Obstet Gynecol
; 29(5): 562-7, 2007 May.
Article
en En
| MEDLINE
| ID: mdl-17444550
OBJECTIVE: To evaluate the efficacy of cervical length measurement in combination with a bedside assessment of phosphorylated insulin-like growth factor-binding protein-1 (phIGFBP-1) as a predictor of preterm delivery in asymptomatic pregnant women with a history of preterm birth. METHODS: Cervical length was measured using transvaginal sonography at 22-24 weeks of gestation in 105 singleton pregnancies and a rapid strip test was performed to detect phIGFBP-1 in cervical secretions from 24 to 34 weeks. Receiver-operating characteristics (ROC) curves were constructed to compare the performance of phIGFBP-1 at different gestational ages, and cervical length at 22-24 weeks, in predicting preterm delivery. RESULTS: The rate of spontaneous delivery before 37 and 34 weeks was 23.8% and 11.4%, respectively. Women with cervical lengths less than 20 mm had a risk of spontaneous preterm delivery before 34 and 37 weeks of 43.5% and 69.6%, respectively. The performance of phIGFBP-1 levels as a predictor of preterm delivery was significantly higher when the test was carried out at 30 weeks' gestation. Cervical assessment in combination with phIGFBP-1 at 30 weeks had the steepest ROC curve (area under the curve=0.93; 95% CI, 0.88-0.98, P<0.001). CONCLUSION: Both cervical length and phIGFBP-1 measurement are useful in the prediction of preterm delivery in patients with a history of preterm birth and the combined method of measuring cervical length at 22-24 weeks and phIGFBP-1 at 30 weeks improves upon either method used alone.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Cuello del Útero
/
Proteína 1 de Unión a Factor de Crecimiento Similar a la Insulina
/
Nacimiento Prematuro
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Evaluation_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Ultrasound Obstet Gynecol
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
/
GINECOLOGIA
/
OBSTETRICIA
Año:
2007
Tipo del documento:
Article
País de afiliación:
Brasil
Pais de publicación:
Reino Unido