Objectives <p>To evaluate the relationship between cervical area (CA) measured by two-dimensional (2D) transvaginal ultrasonography (TVUS) and the latency period in pregnancies complicated by preterm premature rupture of membranes (PPROM), and to compare its predictive performance with that of cervical length (CL).</p> Methods <p>This retrospective cohort study included 164 singleton pregnancies with PPROM (24 + 0–32 + 3&#xa0;weeks). Archived TVUS images obtained within 24&#xa0;h of admission were reanalyzed in a blinded manner. CA (cm<sup>2</sup>), CL (mm), and cervical funneling were recorded. The latency period was defined as the time from membrane rupture to delivery and categorized as short (≤ 10&#xa0;days) or long (&gt; 10&#xa0;days). Group comparisons, correlation analyses, receiver operating characteristic (ROC) curves, and multivariable logistic regression were performed to identify independent predictors.</p> Results <p>Seventy-eight pregnancies had a short latency period. Both CL and CA were significantly lower in the short-latency group. Although the area under the curve (AUC) for CA was higher than that for CL (0.763 vs. 0.678), pairwise comparison using the DeLong test did not show a statistically significant difference (<i>p</i> = 0.064). In the multivariable analysis, cervical funneling (adjusted OR 10.777, 95% CI 4.456–26.063; <i>p</i> &lt; 0.001) and CA (adjusted OR 0.701, 95% CI 0.598–0.822; <i>p</i> &lt; 0.001) remained independent predictors of a short latency, whereas CL lost significance (<i>p</i> = 0.383). CA and CL showed a positive correlation with the latency period (<i>p</i> &lt; 0.001).</p> Conclusions <p>CA measured by 2D-TVUS is an independent predictor of the latency period in PPROM and shows comparable discriminative ability to CL. Incorporating CA assessment may improve risk stratification and aid in timely perinatal management decisions in PPROM pregnancies.</p>

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A new perspective on predicting latency period in preterm premature rupture of membranes: the role of cervical area measurement

  • Yücel Kaya,
  • Emrah Dagdeviren,
  • İlteriş Yaman,
  • Can Tercan,
  • Ali Selçuk Yeniocak,
  • Verda Alpay

摘要

Objectives

To evaluate the relationship between cervical area (CA) measured by two-dimensional (2D) transvaginal ultrasonography (TVUS) and the latency period in pregnancies complicated by preterm premature rupture of membranes (PPROM), and to compare its predictive performance with that of cervical length (CL).

Methods

This retrospective cohort study included 164 singleton pregnancies with PPROM (24 + 0–32 + 3 weeks). Archived TVUS images obtained within 24 h of admission were reanalyzed in a blinded manner. CA (cm2), CL (mm), and cervical funneling were recorded. The latency period was defined as the time from membrane rupture to delivery and categorized as short (≤ 10 days) or long (> 10 days). Group comparisons, correlation analyses, receiver operating characteristic (ROC) curves, and multivariable logistic regression were performed to identify independent predictors.

Results

Seventy-eight pregnancies had a short latency period. Both CL and CA were significantly lower in the short-latency group. Although the area under the curve (AUC) for CA was higher than that for CL (0.763 vs. 0.678), pairwise comparison using the DeLong test did not show a statistically significant difference (p = 0.064). In the multivariable analysis, cervical funneling (adjusted OR 10.777, 95% CI 4.456–26.063; p < 0.001) and CA (adjusted OR 0.701, 95% CI 0.598–0.822; p < 0.001) remained independent predictors of a short latency, whereas CL lost significance (p = 0.383). CA and CL showed a positive correlation with the latency period (p < 0.001).

Conclusions

CA measured by 2D-TVUS is an independent predictor of the latency period in PPROM and shows comparable discriminative ability to CL. Incorporating CA assessment may improve risk stratification and aid in timely perinatal management decisions in PPROM pregnancies.