Ebru Celik

Cervical length and obstetric history predict spontaneous preterm birth: development and validation of a model to provide individualized risk assessment.

To evaluate the ability of combinations of cervical length and maternal history to assess the risk of spontaneous preterm birth, and to provide a simple procedure for the optimal estimation of risk.

Cervical length and maternal factors in expectantly managed prolonged pregnancy : prediction of onset of labor and mode of delivery

To examine the value of combining cervical length and maternal characteristics in a prolonged‐pregnancy clinic in the prediction of the probability of firstly, spontaneous onset of labor within the subsequent 10 days and secondly, the need for Cesarean section.

OC140: Assessing the risk of spontaneous preterm birth using ultrasonic cervical length measurement and maternal characteristics

measurement of the cervix better reflects the engineering principle that greater tissue volume equals greater resistance to dilatation than cervical length. The aim of the study was to determine if cervical volume is a more reliable predictor of preterm delivery than cervical length. Methods: Patients were recruited between 19 and 34 weeks’ gestation if they were shown to have uterine contractions and/or cervical change as determined by pelvic examination or abnormally short (< 28 mm) cervical length. The cervical length and cervical volume were obtained using standard transvaginal 2D and 3D study. Delivery information was subsequently obtained. Data pertaining to cervical length and cervical volume were analyzed postpartum. Results: To date, cervical length, cervical volume and outcome parameters are available for 37 patients. Twenty-two of these patients delivered preterm (< 37 weeks GA). The mean gestational age at delivery (preterm) was 31.4 + 4.1 weeks. Mean maternal age was 22.28 + 6.67 years. Cervical volume was more predictive of risk for preterm delivery than cervical length (sensitivity 95.5%, specificity 73.4%, positive predictive value 84%, negative predictive value 91.7%). Based on the limited data available to date, ROC analysis demonstrated that cervical volume is a better predictor of preterm delivery risk. The area under the curve was 854 for cervical volume vs. 721 for cervical length. Conclusions: Our data strongly suggest that cervical volume is a better predictor of preterm delivery than cervical length. We continue to actively recruit patients to reach the number of patients needed statistically to conclude the study.

OC186: Cervical length at mid-gestation and the risk of primary Cesarean section at term

aim of this study was to explore the value of 3DXI in the evaluation of these structures in the mid-trimester. Methods: Twenty women who presented for a detailed secondtrimester scan agreed to participate in this study, all of whom had normal infants at birth. Ultrasonographic examination was performed with a high-resolution 3D ultrasound machine (Accuvix XQ, Medison). A mechanical broadband transabdominal transducer was used to obtain volumes from the fetal brain (n = 20) and the fetal heart (n = 20) using a 65◦ sweep. Volumes were analyzed offline using 3DXI PC Viewer software and the following brain structures were assessed: both lateral ventricles, third ventricle, cavum septum pellucidum, cerebellum and cisterna magna. Similarly, the following cardiac structures were also evaluated: four-chamber view, outflow tracts (aorta and pulmonary artery), and the three vessels in the upper mediastinum. Results: Regarding the brain structures, one atrium was identified in 20 of the cases (100%), two atria in 18 (90%), the third ventricle in 14 (70%), the cerebellum in 18 (90%), the cisterna magna in 18 (90%) and the corpus callosum in seven (35%). Regarding the cardiac structures, the four-chamber view was visualized in all 20 (100%), the aortic outflow tract in 19 (95%), the pulmonary artery outflow tract in 19 (95%) and the three-vessel view in 18 (90%). Conclusions: 3DXI technology allows interrogation of a single volume of information in multiple planes so that sequential planes of the fetal anatomy can be evaluated at a glance. As the quality of 3D images is highly dependent on the quality of the conventional two-dimensional image, reconstruction of structures in the cerebral midline in the third plane, such as the corpus callosum, may be unreliable.

Progesterone and the Risk of Preterm Birth among Women With a Short Cervix

METHODS Cervical length was measured by transvaginal ultrasonography at a median of 22 weeks of gestation (range, 20 to 25) in 24,620 pregnant women seen for routine prenatal care. Cervical length was 15 mm or less in 413 of the women (1.7%), and 250 (60.5%) of these 413 women were randomly assigned to receive vaginal progesterone (200 mg each night) or placebo from 24 to 34 weeks of gestation. The primary outcome was spontaneous delivery before 34 weeks.