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Second-trimester cervical length as risk indicator for Cesarean delivery in women with twin pregnancy.
- Source :
-
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology [Ultrasound Obstet Gynecol] 2015 Nov; Vol. 46 (5), pp. 579-84. Date of Electronic Publication: 2015 Aug 18. - Publication Year :
- 2015
-
Abstract
- Objective: To determine whether second-trimester cervical length (CL) in women with a twin pregnancy is associated with the risk of emergency Cesarean section.<br />Methods: This was a secondary analysis of two randomized trials conducted in 57 hospitals in The Netherlands. We assessed the univariable association between risk indicators, including second-trimester CL in quartiles, and emergency Cesarean delivery using a logistic regression model. For multivariable analysis, we assessed whether adjustment for other risk indicators altered the associations found in univariable (unadjusted) analysis. Separate analyses were performed for suspected fetal distress and failure to progress in labor as indications for Cesarean section.<br />Results: In total, 311 women with a twin pregnancy attempted vaginal delivery after 34 weeks' gestation. Emergency Cesarean delivery was performed in 111 (36%) women, of which 67 (60%) were performed owing to arrest of labor. There was no relationship between second-trimester CL and Cesarean delivery (adjusted odds ratio (aOR): 0.97 for CL 26(th) -50(th) percentiles; 0.71 for CL 51(st) - 75(th) percentiles; and 0.92 for CL > 75(th) percentile, using CL ≤ 25(th) percentile as reference). In multivariable analysis, the only variables associated with emergency Cesarean delivery were maternal age (aOR, 1.07 (95% CI, 1.00-1.13)), body mass index (BMI) (aOR, 3.99 (95% CI, 1.07-14.9) for BMI 20-23 kg/m(2) ; 5.04 (95% CI, 1.34-19.03) for BMI 24-28 kg/m(2) ; and 3.1 (95% CI, 0.65-14.78) for BMI > 28 kg/m(2) ) and induction of labor (aOR, 1.92 (95% CI, 1.05-3.5)).<br />Conclusion: In nulliparous women with a twin pregnancy, second-trimester CL is not associated with risk of emergency Cesarean delivery.<br /> (Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.)
- Subjects :
- Adult
Female
Humans
Infant, Newborn
Labor, Obstetric
Netherlands epidemiology
Predictive Value of Tests
Pregnancy
Pregnancy Trimester, Second
Randomized Controlled Trials as Topic
Reference Values
Risk Factors
Cervical Length Measurement methods
Cervical Length Measurement statistics & numerical data
Cervix Uteri diagnostic imaging
Cesarean Section statistics & numerical data
Pregnancy Complications diagnostic imaging
Pregnancy, Twin
Subjects
Details
- Language :
- English
- ISSN :
- 1469-0705
- Volume :
- 46
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
- Publication Type :
- Academic Journal
- Accession number :
- 25402630
- Full Text :
- https://doi.org/10.1002/uog.14727