Publication: 22-24. hafta servikal uzunluk ölçümünün preterm doğum prediksiyonundaki yeri, ortalama doğum kilosu ve doğum haftasına etkisi
Abstract
Amaç: Türkiyedeki normal gebe populasyonunda 22-24. gebelik haftasında sonografik olarak servikal uzunluk dağılımını belirleyip bu haftalardaki servikal uzunluğun preterm doğum açısından prediktif değerini saptamak ve Türkiye populasyonunda preterm doğum için servikal uzunluk cut-off değerini belirlemeye çalışmak. Materyal ve Metod: 22-24. gebelik haftaları arasında, 182 tekil gebe hasta prospektif randomize olarak çalışmaya alınarak transvajinal servikal uzunluk ölçüldü. Bu hastalarda doğum sonrasında preterm ve term doğum yapan gebelerin doğum haftaları ve bebeklerin doğum kiloları karşılaştırıldı. Bulgular: Gebelerden 21'i (%13.7) preterm doğum yaptı. Tüm gebelerde servikal uzunluk 19-64 mm arasındaydı. Preterm doğum yapan grupta ortalama servikal uzunluk 29.57±6.56 iken term doğum yapan gebelerde 39.19 ±7.12 olarak bulundu (p<0.0001). Servikal uzunluk ölçümlerinde 31.5 mm eşik değer alındığında %71 sensitivite, %89 spesifıte, %51.85 pozitif prediktif değer, %95.18 negatif prediktif değer ile preterm doğumu tahmin edebilmektedir. Sonuç: Servikal Uzunluk ölçümü bizim popülasyonumuzda 22-24. gebelik haftalarında 31.5 mm eşik değer alındığında preterm doğumu başarılı olarak tahmin edebilmektedir. Ülkemizde de ikinci trimester servikal uzunluk ölçümü her gebeye uygulanan rutin bir işlem haline getirilebilir.
Objective: To determine cervical length distribution by ultrasound between 22"d and 24"' gestational weeks and to determine the predictive cut off values of cervical length for preterm delivery in Turkish women population. Materials and Methods: Cervical length of 184 singleton pregnancies were measured by transvaginal ultrasound. Preterm and term delivery rate and gestational birth weights and gestational weeks of these patients were correlated with the cervical length. Results: Preterm delivery rate of the study group was 13.7% (21 women). The range of cervical length of the study group was 19-64 mm. The mean cervical length of the preterm versus term delivery group was 29.57±6.56 and 39.19 ±7.12 mm respectively (p<0.0001). When 31.5 mm of cervical length was taken as the cut off value for preterm delivery the sensitivity was 71 %, specificity was %89, positive and negative predictive value for the preterm delivery was found to be 51.85 %and %95.18%.respectively. Conclusion: Cervical length measurement successfully predicted the preterm delivery with the cut off value of 31.5mm in Turkish women population. Second trimester cervical length measurement can become a routine procedure to predict preterm delivery. High risk patients for preterm delivery can be informed and followed up accordingly.
Objective: To determine cervical length distribution by ultrasound between 22"d and 24"' gestational weeks and to determine the predictive cut off values of cervical length for preterm delivery in Turkish women population. Materials and Methods: Cervical length of 184 singleton pregnancies were measured by transvaginal ultrasound. Preterm and term delivery rate and gestational birth weights and gestational weeks of these patients were correlated with the cervical length. Results: Preterm delivery rate of the study group was 13.7% (21 women). The range of cervical length of the study group was 19-64 mm. The mean cervical length of the preterm versus term delivery group was 29.57±6.56 and 39.19 ±7.12 mm respectively (p<0.0001). When 31.5 mm of cervical length was taken as the cut off value for preterm delivery the sensitivity was 71 %, specificity was %89, positive and negative predictive value for the preterm delivery was found to be 51.85 %and %95.18%.respectively. Conclusion: Cervical length measurement successfully predicted the preterm delivery with the cut off value of 31.5mm in Turkish women population. Second trimester cervical length measurement can become a routine procedure to predict preterm delivery. High risk patients for preterm delivery can be informed and followed up accordingly.