title: Role of transvaginal sonographic cervical length in predicting spontaneous preterm delivery in triplet pregnancies with therapeutic cerclage.
abstract: 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.
authors: Department of Obstetrics and Gynecology, Georgetown University Hospital, 3800 Reservoir Road, NW-3PHC, Washington, DC 20007, USA. shp2@gunet.georgetown.edu
authors: Sarah H
authors: SH
authors: Poggi
authors: Alessandro
authors: A
authors: Ghidini
authors: Helain J
authors: HJ
authors: Landy
authors: Rodney
authors: R
authors: McLaren
authors: Yinka
authors: Y
authors: Oyelese
authors: Manuel
authors: M
authors: Alvarez
authors: John C
authors: JC
authors: Pezzullo
authors: Joseph V
authors: JV
authors: Collea
mesh_terms: 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