Role of transvaginal sonographic cervical length in predicting spontaneous preterm delivery in triplet pregnancies with therapeutic cerclage.
OBJECTIVE
To assess the role of transvaginal sonographic cervical length in predicting spontaneous preterm delivery at < 32 weeks in patients with both triplet pregnancy and therapeutic cerclage.


METHODS
The maternal records of all triplet pregnancies with therapeutic cerclage and sonographic cervical length before and after cerclage were reviewed (n = 17). Each of these triplet gestations was matched with 2 triplet pregnancies without cerclage based on cervical length after cerclage (+/- 0.5 cm) and gestational age (+/- 3 weeks). Statistical analysis included Fisher's exact test or chi 2 analysis, one-way analysis of variance, logistic regression analysis and receiver operating characteristic curve analysis.


RESULTS
Cerclage was placed at a gestational age of 19.0 +/- 3.1 weeks (mean +/- SD) and increased cervical length from 2.0 +/- 0.7 cm to 3.1 +/- 1.4 cm (P < .05). The rate of spontaneous preterm delivery at < 32 weeks was higher among cases than controls (7/17 vs. 4/27, P = .08). Logistic regression analysis demonstrated that only postcerclage cervical length was predictive of spontaneous preterm delivery at < 32 weeks, with a cervical length of 3.3 cm the optimal predictor.


CONCLUSIONS
In women with triplets and therapeutic cerclage, the only significant predictor of spontaneous preterm delivery at < 32 weeks is cervical length after cerclage placement.
Poggi
Sarah H
SH
Department of Obstetrics and Gynecology, Georgetown University Hospital, 3800 Reservoir Road, NW-3PHC, Washington, DC 20007, USA. shp2@gunet.georgetown.edu
Ghidini
Alessandro
A
Landy
Helain J
HJ
McLaren
Rodney
R
Oyelese
Yinka
Y
Alvarez
Manuel
M
Pezzullo
John C
JC
Collea
Joseph V
JV
D000328:Adult; D016022:Case-Control Studies; D023802:Cerclage, Cervical; D002584:Cervix Uteri / Q000000981:diagnostic imaging*; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008499:Medical Records; D009515:New Jersey / Q000453:epidemiology; D007752:Obstetric Labor, Premature / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D011237:Predictive Value of Tests; D011247:Pregnancy; D012189:Retrospective Studies; D014310:Triplets; D016216:Ultrasonography, Prenatal