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Park, Choi, Lee, Yang, Lee, Song, Moon, Kim, and Lee: The predictive value of postoperative cervical length after emergent and urgent cervical cerclage as a predictive factor of preterm delivery
Original Article
Korean Journal of Obstetrics & Gynecology

Korean Journal of Obstetrics & Gynecology 2011; 54(9): 492-498.

Published online: 26 September 2011

DOI: https://doi.org/10.5468/KJOG.2011.54.9.492

The predictive value of postoperative cervical length after emergent and urgent cervical cerclage as a predictive factor of preterm delivery

Soo Ye Park, MD, Soo Ran Choi, MD, Hea Ran Lee, MD, Sung Cheon Yang, MD, Yong Woo Lee, MD, Ji Eun Song, MD, Jong Soo Moon, MD, Seong Joo Kim, MD, Keun Young Lee, MD

1Department of Obstetrics and Gynecology, Kangnam Sacred Hospital, Hallym University School of Medicine, Seoul, Korea.

Corresponding author: Soo Ran Choi, MD. Deparment of Obstetrics and Gynecology, Kangnam Sacred Hospital, Hallym University School of Medicine, 948-1 Daerim 1-dong, Yeongdeungpo-gu, Seoul 150-950, Korea. Tel: +82-2-2639-5240, Fax: +82-2-2632-7060, csran@hallym.or.kr

Received 18 April 2011       Revised 27 June 2011       Accepted 7 July 2011

Copyright © 2011. Korean Society of Obstetrics and Gynecology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

The aim of this study is to evaluate the value of the ultrasonographic cervical length after emergent and urgent cervical cerclage to prediction of preterm delivery in patients with incompetence of cervix.

Methods

Fifty-one women who underwent emergent cervical cerclage and forty women who underwent urgent cervical cerclage were studied respectively. Receiver-operating characteristic (ROC) curve analysis, Pearson's partial correlation coefficient, and multiple logistic regression analysis were used for statistical analysis.

Results

The mean gestational age at admission was 21.2 ± 2.3 weeks in emergent cerclage group and 21.8 ± 3.2 weeks in urgent cerclage group. Postoperative mean cervical length was 17.6 ± 8.6 mm in emergent group and 21.8 ± 8.7 mm in urgent group. The diagnostic indices of postoperative cervical length (cut-off value 16.5 mm in emergent cerclage, 23.2 mm in urgency cerclage) by ROC curve were sensitivity of 65%, specificity of 45%, positive predictive value of 17%, and negative predictive value of 8% in emergent cerclage group and in urgent cerclage group, sensitivity of 85%, specificity of 50%, positive predictive value of 17%, and negative predictive value of 16%. Multiple logistic regression analysis indicated that postoperative cervical length was not an independent predictor of preterm delivery after adjustment of confounding factors in emergent group (P=0.65) in urgent groups (P=0.77).

Conclusion

In the both groups, the postoperative cervical length was longer than preoperative. However the postoperative cervical length is not a useful predictor of preterm delivery in patients with emergent and urgent cervical cerclage.

Keywords: Cervix cerclage, Cervix insufficient

Figures and Tables

Fig. 1
Cervical measurement obtained after cerclage placement. (A) total length of cervix with the knot of cerclage; (B) width of funneling; (C) depth of funneling.
kjog-54-492-g001
Fig. 2
Receiver operator characteristic curve of post operative cervical length for prediction of preterm birth in urgent and emergent cerclage group.
kjog-54-492-g002
Table 1
Demographic characteristics of patients included
kjog-54-492-i001

Values are presented as mean ± standard deviation (SD) or number (%).

Postop, postoperative; WBC, white blood cell; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein.

Table 2
Relationship between various independent variables and preterm delivery analyzed by multiple logistic regression
kjog-54-492-i002

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