Cervical length measurement for the prediction of preterm birth in symptomatic women with a twin pregnancy: a systematic review and meta-analysis

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2013

Authors

Liem, S.
van de Mheen, L.
Bekedam, D.
van Pampus, M.
Opmeer, B.
Lim, A.
Mol, B.

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Obstetrics and Gynecology International, 2013; 2013:125897-1-125897-7

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S. M. S. Liem, L. van de Mheen, D. J. Bekedam, M. G. van Pampus, B. C. Opmeer, A. C. Lim, and B. W. J. Mol

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Abstract

Objective. The aim of this study was to assess whether cervical length measurement (CL) could predict preterm birth (PTB) in symptomatic women with a twin pregnancy. Methods. We searched MEDLINE and EMBASE to identify studies investigating the accuracy of CL measurement in predicting PTB in symptomatic women with a twin pregnancy. We extracted data to construct two-by-two tables and used bivariate meta-analysis to generate point estimates of sensitivity and specificity. Results. Five studies ( ) were included. Variation in definition of PTB and cut-off points for CL was strong. One study investigated delivery within seven days, demonstrating a sensitivity of 1.0 (95% CI: 0.83–1.0) and a specificity of 0.31 (95% CI 0.2–0.43) for a CL cutoff at 25 mm. Three studies reported on predicting PTB < 37 weeks at a CL cutoff of 30 mm, with sROC point estimates of 0.76 (95% CI: 0.66 to 0.84) and 0.37 (95% CI: 0.21 to 0.56) for sensitivity and specificity, respectively. For preterm birth <34 weeks, no pooled estimates could be estimated since only 2 studies with large heterogeneity were identified. Conclusions. There is limited evidence on the accuracy of cervical length measurement testing the prediction of preterm birth in symptomatic women with a twin pregnancy, especially on the most important outcome, that is, delivery within 7 days.

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© 2013 S. M. S. Liem et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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