Absent Cervical Gland, Cervical Length and Amniotic Fluid Sludge as Predictive Markers of Preterm Birth
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Résumé
Background and Objective Preterm birth is one of the leading causes of neonatal and childhood death worldwide. Despite medical advancements, we often fail to predict and prevent preterm birth. The aim of this study is to evaluate the relationship between three cervical markers: cervical length, absent cervical gland area, and amniotic fluid sludge with the incidence of preterm birth. Material and Methods A prospective, correlational research study, was conducted at the Department of Medical Imaging, Obstetrical Ultrasound Unit, London Health Sciences Centre Victoria Hospital Campus, London, Ontario, Canada from April 1 2014-June 1 2015. The target population was pregnant women, 18 to 45 years of age, who may or may not have a history of preterm labour. The inclusion criteria were singleton pregnancies between 16 and 23 weeks gestation. Participants were excluded if they had a multiple gestation, a fetal demise, fetal anomalies, previous surgeries of the cervix, (i.e. Loop Electrosurgical Excision procedure, cone biopsy), cervical cerclage, placenta previa, and/or any other indication for preterm delivery other than spontaneous labour. Participants were recruited at their antenatal visits or ultrasound appointments and informed consent was obtained. Transvaginal ultrasound of the cervix was performed to assess for cervical length, absent cervical gland area and amniotic fluid sludge and correlated with the incidence of preterm birth. Results Two-hundred and fifteen women participated in this study. Thirteen were removed from the final analysis. The final sampling totalled 202 participants. Twenty-five participants met the criteria for preterm birth, delivering less than 37 weeks gestational age. The prevalence of short cervical length, measuring less than 2.5 cm was 2.3% (4/177) in participants delivered full term and 12% (3/25) among participants that delivered preterm. Absent cervical gland area was 10.2% (18/177) in participants that delivered full term and 16.0% (4/25) among participants that delivered preterm. The prevalence of amniotic fluid sludge was 6.8% (12/177) in participants that delivered full term and 16% (4/25) among participants that delivered preterm. Conclusion Cervical length measurement less than 2.5 cm did prove to be statistically significant with the incidence of preterm birth. Absent cervical gland area and amniotic fluid sludge, however, did not demonstrate a statistically significant correlation. Cervical length measurement, absent cervical gland area and amniotic fluid sludge did not demonstrate an association with chorioamnionitis.
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Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle