{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T03:44:20Z","timestamp":1783741460805,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T00:00:00Z","timestamp":1688601600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Twin pregnancies complicated by twin\u2013twin transfusion syndrome (TTTS) are at particularly high risk of preterm birth. Cervical length (CL) measurement on transvaginal ultrasound (TVS) is a powerful predictor of preterm birth, but the predictive accuracy of CL measurement on magnetic resonance imaging (MRI) has not yet been established. We sought to investigate the correlation between CL measurements obtained on preoperative TVS and on MRI and to quantify their predictive accuracy for preterm birth among pregnancies complicated by TTTS that underwent selective fetoscopic laser photocoagulation (SFLP), to identify whether MRI is a useful adjunct to TVS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study of pregnancies that were treated for TTTS with SFLP at a single center between April 2010 and June 2019 and that underwent TVS and MRI evaluation. Correlation was estimated using Pearson's coefficient, mean CL measurements were compared using the two\u2010tailed paired <jats:italic>t<\/jats:italic>\u2010test and the frequency at which a short cervix was detected by the two imaging modalities was compared using the \u03c7\u2010square test. Generalized linear models were used to estimate relative risk and receiver\u2010operating\u2010characteristics (ROC)\u2010curve analysis was used to estimate the predictive accuracy of CL for preterm birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 626 pregnancies complicated by TTTS that underwent SFLP, CL measurements were obtained on preoperative TVS in 579 cases and on preoperative MRI in 434. CL \u2264\u20092.5\u2009cm was recorded in 39 (6.7%) patients on TVS and 47 (10.8%) patients on MRI (<jats:italic>P<\/jats:italic>\u2009=\u20090.0001). Measurements of CL made on MRI correlated well with those obtained on TVS overall (<jats:italic>r<\/jats:italic>\u2009=\u20090.63), but correlation was weak at the shortest CLs (<jats:italic>r<\/jats:italic>\u2009&lt;\u20090.20). MRI failed to detect two (40.0%), three (18.8%), nine (32.1%) and 13 (28.9%) cases diagnosed as having a short cervix on TVS at cut\u2010offs of \u2264\u20091.5\u2009cm, \u2264\u20092.0\u2009cm, \u2264\u20092.5\u2009cm and \u2264\u20092.8\u2009cm, respectively. Over half of the pregnancies with a preoperative CL of \u2264\u20092.5\u2009cm delivered by 28\u2009weeks' gestation, regardless of imaging modality. CL measurement on TVS was superior to that on MRI to predict preterm birth, the latter performing poorly at all CL cut\u2010offs. A CL measurement of \u2264\u20092.0\u2009cm on preoperative TVS had the highest predictive ability for preterm birth, with an area under the ROC curve for delivery before 32\u2009weeks of 0.82.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although measurement of CL on MRI correlates well with that on TVS overall, it performs poorly at accurately detecting a short cervix. TVS outperforms MRI in evaluation of the cervix and remains the optimal modality for CL measurement in pregnancies at high risk for preterm birth, such as those undergoing SFLP for TTTS. \u00a9 2023 The Authors. <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic> published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.26184","type":"journal-article","created":{"date-parts":[[2023,2,25]],"date-time":"2023-02-25T20:49:45Z","timestamp":1677358185000},"page":"273-278","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prediction of preterm birth by measurement of cervical length on transvaginal ultrasound and magnetic resonance imaging in pregnancies complicated by twin\u2013twin transfusion syndrome and treated with laser surgery"],"prefix":"10.1002","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1441-6627","authenticated-orcid":false,"given":"R.","family":"Fresch","sequence":"first","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology University of Cincinnati College of Medicine  Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Forde","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology University of Cincinnati College of Medicine  Cincinnati OH USA"},{"name":"Cincinnati Fetal Center Cincinnati Children's Hospital Medical Center  Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Habli","sequence":"additional","affiliation":[{"name":"Cincinnati Fetal Center Cincinnati Children's Hospital Medical Center  Cincinnati OH USA"},{"name":"Department of Obstetrics and Gynecology Good Samaritan Hospital  Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9448-6579","authenticated-orcid":false,"given":"H.","family":"Masters","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology University of Cincinnati College of Medicine  Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Tabbah","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology University of Cincinnati College of Medicine  Cincinnati OH USA"},{"name":"Cincinnati Fetal Center Cincinnati Children's Hospital Medical Center  Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"McKinney","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology University of Cincinnati College of Medicine  Cincinnati OH USA"},{"name":"Cincinnati Fetal Center Cincinnati Children's Hospital Medical Center  Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. A.","family":"DeFranco","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology University of Cincinnati College of Medicine  Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001709"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2000.104236"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0223(199712)17:13<1227::AID-PD328>3.0.CO;2-4"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(90)90618-H"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7748"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.10.880"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.22054"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004479"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8545(03)00120-7"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(99)70407-2"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14696"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2009.12.002"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7200292"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sult.2015.07.001"},{"key":"e_1_2_8_16_1","first-page":"1","article-title":"MRI findings in third\u2010trimester opioid\u2010exposed fetuses, with focus on brain measurements: a prospective multicenter case\u2013control study","volume":"18","author":"Nagaraj UD","year":"2023","journal-title":"AJR Am J Roentgenol"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-006-0337-5"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-020-04661-w"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1159\/000304512"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.10.449"},{"key":"e_1_2_8_21_1","unstructured":"The Twin to Twin Transfusion Syndrome Foundation.Occurrence of TTTS; Available from:ttsfoundation.org\/help\u2010during\u2010pregnancy\/diagnosed\u2010with\u2010ttts\/ [Accessed 10\/9\/2021]."},{"issue":"264","key":"e_1_2_8_22_1","first-page":"e1","article-title":"Perioperative characteristics associated with preterm birth in twin\u2013twin transfusion syndrome treated by laser surgery","volume":"209","author":"Chmait RH","year":"2013","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_23_1","article-title":"Cervical Assessment and protocol for measurement. 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