{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T08:27:57Z","timestamp":1769502477413,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,1,27]],"date-time":"2015-01-27T00:00:00Z","timestamp":1422316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2015,2]]},"abstract":"ABSTRACT<\/jats:title>Objectives<\/jats:title>To determine the risk factors for spontaneous preterm delivery (PTD<\/jats:styled-content>) or preterm prelabor rupture of membranes (PPROM<\/jats:styled-content>) at <\u200934\u2009weeks' gestation after fetoscopic laser surgery for twin\u2013twin transfusion syndrome and to identify the optimal threshold for preoperative cervical length (CL<\/jats:styled-content>) that indicates a high risk for spontaneous PTD<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>This was a secondary analysis of data prospectively collected from 449 patients at three fetal centers. CL<\/jats:styled-content> measurements were obtained by preoperative transvaginal ultrasound, at a gestational age of 16\u201326 weeks. The risk factors associated with spontaneous PTD<\/jats:styled-content> before\u200934\u2009weeks' gestation were determined using multivariable logistic regression analysis. We excluded patients with dual fetal demise and those with maternal or fetal indications for delivery without PPROM<\/jats:styled-content> (n<\/jats:italic>\u2009=\u200963). The optimal threshold for cervical length to predict spontaneous PTD<\/jats:styled-content> before\u200934\u2009weeks was determined using a receiver\u2013operating characteristics (ROC<\/jats:styled-content>) curve and Youden index. Additionally, the CL<\/jats:styled-content> threshold for spontaneous PTD<\/jats:styled-content> at 2\u2010week intervals between 24 and 34 weeks was determined.<\/jats:p><\/jats:sec>Results<\/jats:title>Spontaneous PTD<\/jats:styled-content> before\u200934\u2009weeks occurred in 206 (53.4%) of the included patients. Only the preoperative CL<\/jats:styled-content> was significantly associated with spontaneous PTD<\/jats:styled-content>. The preoperative CL<\/jats:styled-content> was normally distributed with a mean of 37.6\u2009\u00b1\u200910.3\u2009mm (range, 5\u201366\u2009mm). Maternal age and parity were positively associated, and gestational age at procedure and anterior placenta were negatively associated, with CL<\/jats:styled-content> on multivariable linear regression analysis. The area under the ROC<\/jats:styled-content> curve for predicting spontaneous PTD<\/jats:styled-content> with CL<\/jats:styled-content> measurements was 0.61 (P<\/jats:italic>\u2009=\u20090.02) and the optimal threshold was 28\u2009mm with a Youden index of 0.19 (sensitivity and specificity of 92% and 27%, respectively). A CL<\/jats:styled-content> measurement of\u2009<\u200928\u2009mm increased the risk of spontaneous PTD<\/jats:styled-content> for all gestational age thresholds.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Spontaneous PTD<\/jats:styled-content> at <\u200934\u2009weeks' gestation is associated with a preoperative CL<\/jats:styled-content> of <\u200928\u2009mm. Preventive strategies should focus on this high\u2010risk group. Copyright \u00a9 2014 ISUOG. Published by John Wiley & Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.14696","type":"journal-article","created":{"date-parts":[[2014,10,16]],"date-time":"2014-10-16T10:35:12Z","timestamp":1413455712000},"page":"175-182","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Cervical length in prediction of preterm birth after laser surgery for twin\u2013twin transfusion syndrome"],"prefix":"10.1002","volume":"45","author":[{"given":"R.","family":"Papanna","sequence":"first","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The Fetal Center at Children's Memorial Hermann Hospital UT Health \u2010 The University of Texas Medical School at Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. K.","family":"Mann","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The Fetal Center at Children's Memorial Hermann Hospital UT Health \u2010 The University of Texas Medical School at Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. A.","family":"Baschat","sequence":"additional","affiliation":[{"name":"Center for Fetal Therapy, Department of Gynecology & Obstetrics Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. W.","family":"Bebbington","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The Fetal Center at Children's Memorial Hermann Hospital UT Health \u2010 The University of Texas Medical School at Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Khalek","sequence":"additional","affiliation":[{"name":"The Children's Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The Fetal Center at Children's Memorial Hermann Hospital UT Health \u2010 The University of Texas Medical School at Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Snowise","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The Fetal Center at Children's Memorial Hermann Hospital UT Health \u2010 The University of Texas Medical School at Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"K. J.","family":"Moise","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The Fetal Center at Children's Memorial Hermann Hospital UT Health \u2010 The University of Texas Medical School at Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,1,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032597"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1798"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2156"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.10.906"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.07.046"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318231827f"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2009.28.5.633"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181d57335"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7476"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13206"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7200292"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12487"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016925309136722"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ede.0000147512.81966.ba"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2000.108896"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(97)70032-2"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)80051-2"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12896"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(15)30835-5"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(99)70111-0"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.05.025"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.02.022"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13445"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.3982"}],"container-title":["Ultrasound in Obstetrics & Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.14696","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.14696","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T05:09:12Z","timestamp":1696482552000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.14696"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,1,27]]},"references-count":24,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2015,2]]}},"alternative-id":["10.1002\/uog.14696"],"URL":"https:\/\/doi.org\/10.1002\/uog.14696","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,1,27]]},"assertion":[{"value":"2014-08-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-10-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-01-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}