Absent Cervical Gland, Cervical Length and Amniotic Fluid Sludge as Predictive Markers of Preterm Birth
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".