Imperial College London
Alternate

DrStefanoCacciatore

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Honorary Research Fellow
 
 
 
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Contact

 

+44 (0)20 7594 2137s.cacciatore

 
 
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Location

 

Institute of Reproductive and Developmental BiologyHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Kindinger:2015:10.1111/1471-0528.13575,
author = {Kindinger, LM and Poon, LC and Cacciatore, S and MacIntyre, DA and Fox, NS and Schuit, E and Mol, BW and Liem, S and Lim, AC and Serra, V and Perales, A and Hermans, F and Darzi, A and Bennett, P and Nicolaides, KH and Teoh, TG},
doi = {10.1111/1471-0528.13575},
journal = {Bjog-An International Journal of Obstetrics and Gynaecology},
pages = {877--884},
title = {The effect of gestational age and cervical length measurements in the prediction of spontaneous preterm birth in twin pregnancies: an individual patient level meta-analysis},
url = {http://dx.doi.org/10.1111/1471-0528.13575},
volume = {123},
year = {2015}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - ObjectiveTo assess the effect of gestational age (GA) and cervical length (CL) measurements at transvaginal ultrasound (TVUS) in the prediction of preterm birth in twin pregnancy.DesignIndividual patient data (IPD) meta-analysis.SettingInternational multicentre study.PopulationAsymptomatic twin pregnancy.MethodsMEDLINE and EMBASE searches were performed and IPD obtained from authors of relevant studies. Multinomial logistic regression analysis determined probabilities for birth at ≤28+0, 28+1 to 32+0, 32+1 to 36+0, and ≥36+1 weeks as a function of GA at screening and CL measurements.Main outcome measuresPredicted probabilities for preterm birth at ≤28+0, 28+1 to 32+0, and 32+1 to 36+0.ResultsA total of 6188 CL measurements were performed on 4409 twin pregnancies in 12 studies. Both GA at screening and CL had a significant and non-linear effect on GA at birth. The best prediction of birth at ≤28+0 weeks was provided by screening at ≤18+0 weeks (P < 0.001), whereas the best prediction of birth between 28+1 and 36+0 weeks was provided by screening at ≥24+0 weeks (P < 0.001). Negative prediction value of 100% for birth at ≤28+0 weeks is achieved at CL 65 mm and 43 mm at ultrasound GA at ≤18+0 weeks and at 22+1 to 24+0 weeks, respectively.ConclusionIn twin pregnancies, prediction of preterm birth depends on both CL and the GA at screening. When CL is <30 mm, screening at ≤18+0 weeks is most predictive for birth at ≤28+0 weeks. Later screening at >22+0 weeks is most predictive of delivery at 28+1 to 36+0 weeks. In twins, we recommend CL screening in twins to commence from ≤18+0 weeks.
AU  - Kindinger,LM
AU  - Poon,LC
AU  - Cacciatore,S
AU  - MacIntyre,DA
AU  - Fox,NS
AU  - Schuit,E
AU  - Mol,BW
AU  - Liem,S
AU  - Lim,AC
AU  - Serra,V
AU  - Perales,A
AU  - Hermans,F
AU  - Darzi,A
AU  - Bennett,P
AU  - Nicolaides,KH
AU  - Teoh,TG
DO  - 10.1111/1471-0528.13575
EP  - 884
PY  - 2015///
SN  - 1471-0528
SP  - 877
TI  - The effect of gestational age and cervical length measurements in the prediction of spontaneous preterm birth in twin pregnancies: an individual patient level meta-analysis
T2  - Bjog-An International Journal of Obstetrics and Gynaecology
UR  - http://dx.doi.org/10.1111/1471-0528.13575
VL  - 123
ER  -
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