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A new screening of preterm birth in gestation with short cervix after pessary plus progesterone.
França, Marcelo Santucci; de Andrade, Valter Lacerda; Hatanaka, Alan Roberto; Santos, Roberto; Carvalho, Francisco Herlanio Costa; Costa, Maria Laura; França, Gabriela Ubeda Santucci; Mattar, Rosiane; Mol, Ben Willem; Moron, Antonio Fernandes; Pacagnella, Rodolfo de Carvalho.
Afiliação
  • França MS; Escola Paulista de Medicina Universidade Federal de São Paulo São PauloSP Brazil Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
  • de Andrade VL; Impacta Digital Academy Data Science São Paulo Brazil Impacta Digital Academy Data Science, São Paulo, Brazil.
  • Hatanaka AR; Escola Paulista de Medicina Universidade Federal de São Paulo São PauloSP Brazil Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
  • Santos R; Impacta Digital Academy Data Science São Paulo Brazil Impacta Digital Academy Data Science, São Paulo, Brazil.
  • Carvalho FHC; Department of Women, Children and Adolescents Health Universidade Federal do Ceará FortalezaCE Brazil Department of Women, Children and Adolescents Health, Universidade Federal do Ceará, Fortaleza, CE, Brazil.
  • Costa ML; Department of Tocogynecology, School of Medical Sciences Universidade Estadual de Campinas CampinasSao Paulo Brazil Department of Tocogynecology, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, Sao Paulo, Brazil.
  • França GUS; Escola Paulista de Medicina Universidade Federal de São Paulo São PauloSP Brazil Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
  • Mattar R; Escola Paulista de Medicina Universidade Federal de São Paulo São PauloSP Brazil Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
  • Mol BW; Department of Obstetrics and Gynaecology Monash University ClaytonVictoria Australia Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia.
  • Moron AF; Escola Paulista de Medicina Universidade Federal de São Paulo São PauloSP Brazil Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
  • Pacagnella RC; Department of Women, Children and Adolescents Health Universidade Federal do Ceará FortalezaCE Brazil Department of Women, Children and Adolescents Health, Universidade Federal do Ceará, Fortaleza, CE, Brazil.
Rev Bras Ginecol Obstet ; 462024.
Article em En | MEDLINE | ID: mdl-39380588
ABSTRACT

Objective:

This study aims to create a new screening for preterm birth < 34 weeks after gestation with a cervical length (CL) ≤ 30 mm, based on clinical, demographic, and sonographic characteristics.

Methods:

This is a post hoc analysis of a randomized clinical trial (RCT), which included pregnancies, in middle-gestation, screened with transvaginal ultrasound. After observing inclusion criteria, the patient was invited to compare pessary plus progesterone (PP) versus progesterone only (P) (11). The objective was to determine which variables were associated with severe preterm birth using logistic regression (LR). The area under the curve (AUC), sensitivity, specificity, and positive predictive value (PPV) and negative predictive value (NPV) were calculated for both groups after applying LR, with a false positive rate (FPR) set at 10%.

Results:

The RCT included 936 patients, 475 in PP and 461 in P. The LR selected ethnics white, absence of previous curettage, previous preterm birth, singleton gestation, precocious identification of short cervix, CL < 14.7 mm, CL in curve > 21.0 mm. The AUC (CI95%), sensitivity, specificity, PPV, and PNV, with 10% of FPR, were respectively 0.978 (0.961-0.995), 83.4%, 98.1%, 83.4% and 98.1% for PP < 34 weeks; and 0.765 (0.665-0.864), 38.7%, 92.1%, 26.1% and 95.4%, for P < 28 weeks.

Conclusion:

Logistic regression can be effective to screen preterm birth < 34 weeks in patients in the PP Group and all pregnancies with CL ≤ 30 mm.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pessários / Progestinas / Progesterona / Colo do Útero / Nascimento Prematuro / Medida do Comprimento Cervical Limite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Rev Bras Ginecol Obstet Assunto da revista: GINECOLOGIA / OBSTETRICIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pessários / Progestinas / Progesterona / Colo do Útero / Nascimento Prematuro / Medida do Comprimento Cervical Limite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Rev Bras Ginecol Obstet Assunto da revista: GINECOLOGIA / OBSTETRICIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil