{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:42:02Z","timestamp":1792644122174,"version":"4.5.0"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,2,8]],"date-time":"2017-02-08T00:00:00Z","timestamp":1486512000000},"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 & Gyne"],"published-print":{"date-parts":[[2017,3]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n Cervical length screening by transvaginal sonography (TVS) has been shown to be a good predictive test for spontaneous preterm birth (PTB) in symptomatic singleton pregnancy with threatened preterm labor (PTL). The aim of this review and meta\u2010analysis of individual participant data was to evaluate the effect of knowledge of the TVS cervical length (CL) in preventing PTB in singleton pregnancies presenting with threatened PTL.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We searched the Cochrane Pregnancy and Childbirth Group's Trials Register and the Cochrane Complementary Medicine Field's Trials Register (May 2016) and reference lists of retrieved studies. Selection criteria included randomized controlled trials of singleton gestations with threatened PTL randomized to management based mainly on CL screening (intervention group), or CL screening with no knowledge of results or no CL screening (control group). Participants included women with singleton gestations at 23 + 0 to 36 + 6 weeks with threatened PTL. We contacted corresponding authors of included trials to request access to the data and perform a meta\u2010analysis of individual participant data. Data provided by the investigators were merged into a master database constructed specifically for the review. The primary outcome was PTB < 37 weeks. Summary measures were reported as relative risk (RR) or as mean difference (MD) with 95% CI.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Three trials including a total of 287 singleton gestations with threatened PTL between 24 + 0 and 35 + 6 weeks were included in the meta\u2010analysis, of which 145 were randomized to CL screening with knowledge of results and 142 to no knowledge of CL. Compared with the control group, women who were randomized to the known CL group had a significantly lower rate of PTB < 37 weeks (22.1%\n vs<\/jats:italic>\n 34.5%; RR, 0.64 (95% CI, 0.44\u20130.94); three trials; 287 participants) and a later gestational age at delivery (MD, 0.64 (95% CI, 0.03\u20131.25) weeks; MD, 4.48 (95% CI, 1.18\u20138.98) days; three trials; 287 participants). All other outcomes for which there were available data were similar in the two groups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n There is a significant association between knowledge of TVS CL and lower incidence of PTB and later gestational age at delivery in symptomatic singleton gestations with threatened PTL. Given that in the meta\u2010analysis we found a significant 36% reduction in the primary outcome, but other outcomes were mostly statistically similar, further study needs to be undertaken to understand better whether the predictive characteristics of CL screening by TVS can be translated into better clinical management and therefore better outcomes and under what circumstances. Copyright \u00a9 2016 ISUOG. Published by John Wiley & Sons Ltd.<\/jats:p>\n <\/jats:sec>\n \n Cribado mediante la longitud cervical para la prevenci\u00f3n del parto pret\u00e9rmino en embarazos con feto \u00fanico y riesgo de parto prematuro: revisi\u00f3n sistem\u00e1tica y metaan\u00e1lisis de ensayos controlados aleatorizados haciendo uso de los datos individuales de las pacientes<\/jats:title>\n \n RESUMEN<\/jats:bold>\n <\/jats:p>\n <\/jats:sec>\n \n Objetivo<\/jats:title>\n El cribado mediante la longitud cervical obtenida con ecograf\u00eda transvaginal (ETV) ha demostrado ser una buena prueba para la predicci\u00f3n del parto pret\u00e9rmino espont\u00e1neo (PPTE) en embarazos con feto \u00fanico sintom\u00e1ticos debido a la amenaza de parto pret\u00e9rmino (PPT). El objetivo de esta revisi\u00f3n y metaan\u00e1lisis de los datos de participantes individuales fue evaluar el efecto de medir la longitud cervical (LC) mediante ETV con el fin de prevenir el parto prematuro en embarazos \u00fanicos con amenaza de PPT.<\/jats:p>\n <\/jats:sec>\n \n M\u00e9todos<\/jats:title>\n \n Se realizaron b\u00fasquedas en los ficheros de ensayos de Cochrane\n Pregnancy and Childbirth Group<\/jats:italic>\n y\n Complementary Medicine Field<\/jats:italic>\n (mayo de 2016), y en las listas de referencias de los estudios encontrados. Los criterios de selecci\u00f3n incluyeron ensayos controlados aleatorizados de embarazos con feto \u00fanico y riesgo de PPT con aleatorizaci\u00f3n de la paciente basada principalmente en el cribado mediante la LC (grupo de intervenci\u00f3n), el cribado mediante la LC sin conocimiento de los resultados, o sin cribado de LC (grupo de control). Las participantes fueron mujeres embarazadas con feto \u00fanico desde las 23 + 0 hasta las 36 + 6 semanas y con riesgo de PPT. Se estableci\u00f3 contacto con los autores de los ensayos incluidos para solicitar el acceso a los datos y llevar a cabo un metaan\u00e1lisis de los datos de las participantes individualmente. Los datos proporcionados por los investigadores se agregaron a una base de datos maestra creada espec\u00edficamente para esta revisi\u00f3n. El resultado primario fue el PPTE < 37 semanas. Las medidas resumen se reportaron como riesgo relativo (RR) o como diferencia de medias (DM) con IC del 95%.\n <\/jats:p>\n <\/jats:sec>\n \n Resultados<\/jats:title>\n En el metaan\u00e1lisis se incluyeron tres ensayos con un total de 287 embarazos con feto \u00fanico y riesgo de PPT entre 24 + 0 y 35 + 6 semanas, de los cuales 145 fueron asignados al azar a un cribado mediante la LC con conocimiento de los resultados y 142 a aquellos para los que se desconoc\u00eda la LC. En comparaci\u00f3n con el grupo control, las mujeres que fueron asignadas aleatoriamente al grupo en el que se conoc\u00eda la LC tuvieron una tasa de parto prematuro a < 37 semanas significativamente menor (22,1% vs. 34,5%; RR 0,64 (IC 95%, 0,44\u20130,94); 3 ensayos; 287 participantes ) y una edad gestacional al momento del parto m\u00e1s tard\u00eda (DM 0,64 (IC 95%, 0.03\u20131.25) semanas; DM 4,48 (IC 95%, 1,18\u20138,98) d\u00edas; 3 ensayos; 287 participantes). El resto de los resultados para los cuales hab\u00eda datos disponibles fueron similares en ambos grupos.<\/jats:p>\n <\/jats:sec>\n \n Conclusiones<\/jats:title>\n Existe una asociaci\u00f3n significativa entre el conocimiento de la LC obtenida mediante ETV y una menor incidencia de PPTE y edad gestacional m\u00e1s tard\u00eda en el momento del parto en embarazos con feto \u00fanico sintom\u00e1ticos debido al riesgo de parto pret\u00e9rmino (PPT). Teniendo en cuenta que en el metaan\u00e1lisis se encontr\u00f3 una reducci\u00f3n significativa del 36% en el resultado primario, pero que los otros resultados fueron estad\u00edsticamente similares en su mayor\u00eda, ser\u00e1n necesarios m\u00e1s estudios para entender mejor si las propiedades predictivas del cribado mediante la LC obtenida con ETV se pueden traducir en una mejor atenci\u00f3n cl\u00ednica y por lo tanto mejores resultados dependiendo de las circunstancias.<\/jats:p>\n <\/jats:sec>\n \n \u51fa\u73b0\u5148\u5146\u65e9\u4ea7\u7684\u5355\u80ce\u598a\u5a20\u4e2d\u7b5b\u67e5\u5bab\u9888\u957f\u5ea6\u9884\u9632\u65e9\u4ea7\u7684\u53d1\u751f:\u91c7\u7528\u5355\u4e2a\u75c5\u4f8b\u6570\u636e\u8fdb\u884c\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u7684\u7cfb\u7edf\u7efc\u8ff0\u548cmeta\u5206\u6790<\/jats:title>\n <\/jats:sec>\n \n \u76ee\u7684<\/jats:title>\n \n \u5df2\u6709\u7814\u7a76\u663e\u793a,\u5728\u51fa\u73b0\u5148\u5146\u65e9\u4ea7(preterm labor,\n PTL<\/jats:styled-content>\n )\u7684\u6709\u75c7\u72b6\u7684\u5355\u80ce\u598a\u5a20\u4e2d,\u91c7\u7528\u7ecf\u9634\u9053\u8d85\u58f0\u68c0\u67e5(transvaginal sonography,\n TVS<\/jats:styled-content>\n )\u8fdb\u884c\u5bab\u9888\u957f\u5ea6\u7b5b\u67e5\u662f\u4e00\u79cd\u5f88\u597d\u7684\u9884\u6d4b\u81ea\u53d1\u6027\u65e9\u4ea7(spontaneous preterm birth,\n PTB<\/jats:styled-content>\n )\u53d1\u751f\u7684\u65b9\u6cd5\u3002\n \u672c\u7bc7\u5bf9\u5355\u4e2a\u75c5\u4f8b\u6570\u636e\u7684\u7efc\u8ff0\u548cmeta\u5206\u6790\u7684\u76ee\u7684\u662f\u8bc4\u4f30\u5728\u51fa\u73b0\u5148\u5146PTL\u7684\u5355\u80ce\u598a\u5a20\u4e2d<\/jats:styled-content>\n ,\n \u77e5\u6653TVS\u5bab\u9888\u957f\u5ea6<\/jats:styled-content>\n (cervical length,\n CL<\/jats:styled-content>\n )\n \u5bf9\u9884\u9632PTB\u7684\u4f5c\u7528<\/jats:styled-content>\n \u3002\n <\/jats:p>\n <\/jats:sec>\n \n \u65b9\u6cd5<\/jats:title>\n \n \u68c0\u7d22Cochrane\u598a\u5a20\u548c\u5206\u5a29\u7ec4\u8bd5\u9a8c\u6ce8\u518c\u8d44\u6599\u5e93\u548cCochrane\u8f85\u52a9\u533b\u5b66\u8bd5\u9a8c\u6ce8\u518c\u8d44\u6599\u5e93<\/jats:styled-content>\n (2016\u5e745\u6708)\u4ee5\u53ca\u68c0\u7d22\u5230\u7684\u7814\u7a76\u7684\u53c2\u8003\u6587\u732e\u5217\u8868\u3002\n \u7eb3\u5165\u6807\u51c6\u4e3a\u51fa\u73b0\u5148\u5146PTL\u7684\u5355\u80ce\u598a\u5a20\u7684\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c<\/jats:styled-content>\n ,\n \u968f\u673a\u5206\u4e3a\u4e3b\u8981\u6839\u636eCL\u7b5b\u67e5\u7ed3\u679c\u8fdb\u884c\u5904\u7406<\/jats:styled-content>\n (\u5e72\u9884\u7ec4)\n \u6216\u8005\u8fdb\u884cCL\u7b5b\u67e5\u4f46\u4e0d\u77e5\u6653\u7ed3\u679c\u6216\u672a\u8fdb\u884cCL\u7b5b\u67e5<\/jats:styled-content>\n (\u5bf9\u7167\u7ec4)\u3002\u7814\u7a76\u5bf9\u8c61\u4e3a\u5b5523 + 0\u5468\u81f3\u5b5536+\n 6\u5468\u51fa\u73b0\u5148\u5146PTL\u7684\u5355\u80ce\u598a\u5a20\u5b55\u5987<\/jats:styled-content>\n \u3002\u6211\u4eec\u4e0e\u7eb3\u5165\u8bd5\u9a8c\u7684\u901a\u4fe1\u4f5c\u8005\u53d6\u5f97\u8054\u7cfb,\u83b7\u51c6\u4f7f\u7528\u6570\u636e,\u5e76\u8fdb\u884c\u5355\u4e2a\u75c5\u4f8b\u6570\u636e\u7684meta\u5206\u6790\u3002\u5c06\u7814\u7a76\u4eba\u5458\u63d0\u4f9b\u7684\u6570\u636e\u5408\u5e76\u5230\u7279\u522b\u5efa\u7acb\u7684\u4e3b\u6570\u636e\u5e93\u4e2d\u4ee5\u8fdb\u884c\u8bc4\u4ef7\u3002\n \u4e3b\u8981\u7ed3\u5c40\u4e3a\u5b5537\u5468\u524d\u53d1\u751fPTB<\/jats:styled-content>\n \u3002\u7efc\u5408\u68c0\u6d4b\u7ed3\u679c\u4ee5\u76f8\u5bf9\u5371\u9669\u5ea6(relative risk,\n RR<\/jats:styled-content>\n )\u6216\u5e73\u5747\u5dee\u548c95%\n CI<\/jats:styled-content>\n (mean difference,\n MD<\/jats:styled-content>\n )\u8868\u793a\u3002\n <\/jats:p>\n <\/jats:sec>\n \n \u7ed3\u679c<\/jats:title>\n \n meta\u5206\u6790\u7eb3\u51653\u9879\u8bd5\u9a8c,\u5171\u5305\u62ec287\u4f8b\u5728\u5b5524 + 0\u5468\u81f3\u5b5535+\n 6\u5468\u95f4\u51fa\u73b0\u5148\u5146PTL\u7684\u5355\u80ce\u598a\u5a20<\/jats:styled-content>\n ,\n \u5176\u4e2d145\u4f8b\u968f\u673a\u5206\u81f3\u77e5\u6653\u7ed3\u679c\u7684CL\u7b5b\u67e5\u7ec4<\/jats:styled-content>\n ,\n 142\u4f8b\u5206\u81f3\u4e0d\u77e5\u6653CL\u7ec4<\/jats:styled-content>\n \u3002\u4e0e\u5bf9\u7167\u7ec4\u76f8\u6bd4,\n \u968f\u673a\u5206\u81f3\u77e5\u6653CL\u7ec4\u7684\u5b55\u5987\u5b5537\u5468\u524dPTB\u53d1\u751f\u7387\u660e\u663e\u8f83\u4f4e<\/jats:styled-content>\n [22.1%\u548c34.5%;\n RR<\/jats:styled-content>\n ,0.64(95%\n CI<\/jats:styled-content>\n ,0.44 ~ 0.94);3\u9879\u8bd5\u9a8c;287\u540d\u7814\u7a76\u5bf9\u8c61],\u5206\u5a29\u5b55\u5468\u5ef6\u957f[\n MD<\/jats:styled-content>\n ,0.64(95%\n CI<\/jats:styled-content>\n ,0.03 ~ 1.25)\u5468;\n MD<\/jats:styled-content>\n ,4.48(95%\n CI<\/jats:styled-content>\n ,1.18 ~ 8.98)\u5929;3\u9879\u8bd5\u9a8c;287\u7814\u7a76\u5bf9\u8c61]\u30022\u7ec4\u76f8\u6bd4,\u73b0\u6709\u6570\u636e\u7684\u6240\u6709\u5176\u4ed6\u7ed3\u5c40\u76f8\u4f3c\u3002\n <\/jats:p>\n <\/jats:sec>\n \n \u7ed3\u8bba<\/jats:title>\n \n \u51fa\u73b0\u5148\u5146PTL\u7684\u6709\u75c7\u72b6\u7684\u5355\u80ce\u598a\u5a20\u4e2d<\/jats:styled-content>\n ,\n \u77e5\u6653TVS CL\u4e0ePTB\u53d1\u75c5\u7387\u8f83\u4f4e\u548c\u5206\u5a29\u5b55\u5468\u5ef6\u957f\u5448\u663e\u8457\u76f8\u5173<\/jats:styled-content>\n \u3002\u9274\u4e8e\u5728meta\u5206\u6790\u4e2d\u6211\u4eec\u53d1\u73b0\u4e3b\u8981\u7ed3\u5c40\u53d1\u751f\u7387\u663e\u8457\u964d\u4f4e36%,\u800c\u5176\u4ed6\u7ed3\u5c40\u5927\u591a\u7edf\u8ba1\u5b66\u76f8\u4f3c,\u56e0\u6b64\u9700\u8981\u8fdb\u884c\u8fdb\u4e00\u6b65\u7814\u7a76,\n \u4ee5\u66f4\u6df1\u5165\u4e86\u89e3\u91c7\u7528TVS\u8fdb\u884cCL\u7b5b\u67e5\u7684\u9884\u6d4b\u7279\u70b9\u80fd\u5426\u4ee5\u53ca\u5728\u4f55\u79cd\u60c5\u51b5\u4e0b\u53ef\u4ee5\u7528\u4e8e\u8fdb\u884c\u66f4\u597d\u7684\u4e34\u5e8a\u7ba1\u7406<\/jats:styled-content>\n ,\u4ece\u800c\u5f97\u5230\u66f4\u597d\u7684\u7ed3\u5c40\u3002\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/uog.17388","type":"journal-article","created":{"date-parts":[[2016,12,20]],"date-time":"2016-12-20T08:36:46Z","timestamp":1482223006000},"page":"322-329","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":131,"title":["Cervical length screening for prevention of preterm birth in singleton pregnancy with threatened preterm labor: systematic review and meta\u2010analysis of randomized controlled trials using individual patient\u2010level data"],"prefix":"10.1002","volume":"49","author":[{"given":"V.","family":"Berghella","sequence":"first","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology Sidney Kimmel Medical College of Thomas Jefferson University Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Palacio","sequence":"additional","affiliation":[{"name":"BCNatal \u2013 Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u), IDIBAPS University of Barcelona, Barcelona, Spain and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER) Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Ness","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology Stanford University Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z.","family":"Alfirevic","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health University of Liverpool and Liverpool Women's Hospital Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. H.","family":"Nicolaides","sequence":"additional","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine Kings College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Saccone","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine University of Naples Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,2,8]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"1","article-title":"Births: final data for 2014","volume":"64","author":"Hamilton BE","year":"2015","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2013.10.008"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2012.657278"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007235.pub3"},{"key":"e_1_2_5_6_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins JPT","year":"2011"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.3656"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.3908"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.07.017"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.3294"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.04.038"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2005.04.007"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i5044"},{"key":"e_1_2_5_14_1","volume-title":"Obstetric Evidence\u2010Based Guidelines (3rd edn)","author":"Armson AB","year":"2017"},{"key":"e_1_2_5_15_1","first-page":"33","article-title":"Relationship of antepartum pelvic examinations to premature rupture of the membranes","volume":"63","author":"Lenihan JP","year":"1984","journal-title":"Obstet Gynecol"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(85)90667-2"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-999782"}],"container-title":["Ultrasound in Obstetrics & Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.17388","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.17388","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.17388","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.17388","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T04:32:41Z","timestamp":1747110761000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.17388"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,2,8]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2017,3]]}},"alternative-id":["10.1002\/uog.17388"],"URL":"https:\/\/doi.org\/10.1002\/uog.17388","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,2,8]]},"assertion":[{"value":"2016-10-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-12-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-02-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}