{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T12:58:05Z","timestamp":1740142685890,"version":"3.37.3"},"reference-count":23,"publisher":"Federa\u00e7\u00e3o das Associa\u00e7\u00f5es de Ginecologia e Obstetr\u00edcia","issue":"04","license":[{"start":{"date-parts":[[2023,5,24]],"date-time":"2023-05-24T00:00:00Z","timestamp":1684886400000},"content-version":"vor","delay-in-days":53,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Bras Ginecol Obstet"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003To describe a reference curve for cervical length (CL) in mid-trimester twin gestations using transvaginal ultrasound (TVU) and to investigate whether short CL increases spontaneous preterm birth (sPTB) in asymptomatic twin pregnancies.<\/jats:p><jats:p>\n          Methods\u2003This was a prospective cohort study performed at 17 outpatient antenatal facilities of Brazil with women at 18 0\/7 to 22 6\/7 weeks of gestation who participated in a randomized clinical trial screening phase (P5 trial) between July 2015 and March 2019. TVU was performed to provide CL measurement in all screened women. Almost all women with CL \u2264 30\u2009mm received vaginal progesterone 200mg\/day and they were also randomized to receive cervical pessary or not. We considered data from the CL distribution among asymptomatic twin pregnancies and analyzed CL and its association with PTB generating receiver operating characteristics (ROC) curves and Kaplan-Meier curves.<\/jats:p><jats:p>\n          Results\u2003A total of 253 pregnant women with twins were included in the distribution curve. The mean CL was 33.7\u2009mm and median was 35.5mm. The 10th percentile was 17.8mm. We identified a PTB rate of 73.9% (187\/253) with 33.6% of sPTB\u2009&lt;\u200937 (85\/253) and 15% (38\/253) of sPTB\u2009&lt;\u200934 weeks. The best cutoff point to predict sPTB\u2009&lt;\u200937 was 24.15\u2009mm. However, the ROC curve showed a poor performance (0.64). The Kaplan-Meier survival curves identified that only CL values \u2264 20mm were associated to sPTB\u2009&lt;\u200934 weeks.<\/jats:p><jats:p>\n          Conclusion\u2003A cutoff point of CL \u2264 20\u2009mm can be interesting point to identify short cervix in Brazilian twin pregnancies. However, in Brazilian asymptomatic twin pregnancies, CL does not show a good performance to predict PTB.<\/jats:p>","DOI":"10.1055\/s-0043-1769467","type":"journal-article","created":{"date-parts":[[2023,5,24]],"date-time":"2023-05-24T22:48:11Z","timestamp":1684968491000},"page":"171-178","source":"Crossref","is-referenced-by-count":1,"title":["The Use of Mid-Pregnancy Cervical Length to Predict Preterm Birth in Brazilian Asymptomatic Twin Gestations"],"prefix":"10.61622","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8718-5372","authenticated-orcid":false,"given":"Tha\u00eds Val\u00e9ria","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, University of Campinas, Campinas, SP, Brazil"},{"name":"CISAM Maternity Hospital, University of Pernambuco, Recife, PE, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2659-6012","authenticated-orcid":false,"given":"Anderson","family":"Borovac-Pinheiro","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, University of Campinas, Campinas, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5145-1061","authenticated-orcid":false,"given":"Marcelo Santucci","family":"Fran\u00e7a","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Screening and Prevention of Preterm Birth Sector, Discipline of Fetal Medicine, Escola Paulista de Medicina, Federal University of Sao Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1859-7947","authenticated-orcid":false,"given":"Kaline Fernandes","family":"Marquat","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, University of Campinas, Campinas, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5249-858X","authenticated-orcid":false,"given":"Juliana Passos","family":"Argenton","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, University of Campinas, Campinas, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8337-550X","authenticated-orcid":false,"given":"Ben Willem","family":"Mol","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecologic, Monash University, Clayton, Victoria, Australia"},{"name":"Aberdeen Centre for Women's Health Research, University of Aberdeen, Aberdeen, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5739-0009","authenticated-orcid":false,"given":"Rodolfo Carvalho","family":"Pacagnella","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, University of Campinas, Campinas, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"47794","published-online":{"date-parts":[[2023,5,24]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"publisher","first-page":"e0245152","DOI":"10.1371\/journal.pone.0245152","article-title":"Twin pregnancy and perinatal outcomes: Data from \u2018Birth in Brazil Study\u2019","volume":"16","author":"A P Esteves-Pereira","year":"2021","journal-title":"PLoS One"},{"issue":"09","key":"ref2","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1055\/s-0038-1668117","article-title":"Multiple pregnancy: epidemiology and association with maternal and perinatal morbidity","volume":"40","author":"D S Santana","year":"2018","journal-title":"Rev Bras Ginecol Obstet"},{"issue":"S 03","key":"ref3","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/s1472-6483(10)62251-1","article-title":"Global epidemiology of multiple birth","volume":"15","author":"J Collins","year":"2007","journal-title":"Reprod Biomed Online"},{"issue":"10","key":"ref4","doi-asserted-by":"publisher","first-page":"e109069","DOI":"10.1371\/journal.pone.0109069","article-title":"Brazilian multicentre study on preterm birth (EMIP): prevalence and factors associated with spontaneous preterm birth","volume":"9","author":"R Passini Jr","year":"2014","journal-title":"PLoS One"},{"issue":"01","key":"ref5","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1038\/s41598-020-57810-4","article-title":"Clinical and epidemiological factors associated with spontaneous preterm birth: a multicentre cohort of low risk nulliparous women","volume":"10","author":"R T Souza","year":"2020","journal-title":"Sci Rep"},{"issue":"03","key":"ref6","doi-asserted-by":"publisher","first-page":"288.e1","DOI":"10.1016\/j.ajog.2020.09.002","article-title":"Personalized assessment of cervical length improves prediction of spontaneous preterm birth: a standard and a percentile calculator","volume":"224","author":"D W Gudicha","year":"2021","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref7","doi-asserted-by":"publisher","first-page":"907","DOI":"10.1097\/AOG.0000000000002884","article-title":"Cervical pessary compared with vaginal progesterone for preventing early preterm birth: a randomized controlled trial","volume":"132","author":"S Cruz-Melguizo","year":"2018","journal-title":"Obstet Gynecol"},{"issue":"02","key":"ref8","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1016\/j.ajog.2017.11.576","article-title":"Vaginal progesterone for preventing preterm birth and adverse perinatal outcomes in singleton gestations with a short cervix: a meta-analysis of individual patient data","volume":"218","author":"R Romero","year":"2018","journal-title":"Am J Obstet Gynecol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1016\/s0002-9378(96)80051-2","article-title":"The preterm prediction study: risk factors in twin gestations","volume":"175","author":"R L Goldenberg","year":"1996","journal-title":"Am J Obstet Gynecol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1016\/j.ejogrb.2021.04.023","article-title":"Role of progesterone, cerclage and pessary in preventing preterm birth in twin pregnancies: A systematic review and network meta-analysis","volume":"261","author":"F D'Antonio","year":"2021","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"S298","DOI":"10.1016\/j.ajog.2015.10.598","article-title":"554: distribution of transvaginal cervical length in an unselected cohort of twin pregnancies","volume":"214","author":"C Brock","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"116S","DOI":"10.1097\/01.AOG.0000533495.84832.0f","article-title":"Comparison of management options for twin pregnancies affected by midtrimester incidental cervical shortening","volume":"131","author":"E Qureshey","year":"2018","journal-title":"Obstet Gynecol"},{"issue":"01","key":"ref13","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1097\/AOG.0000000000004634","article-title":"Pessary plus progesterone to prevent preterm birth in women with short cervixes: a randomized controlled trial","volume":"139","author":"R C Pacagnella","year":"2022","journal-title":"Obstet Gynecol"},{"issue":"04","key":"ref14","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1111\/aogs.12843","article-title":"Prenatal administration of vaginal progesterone and frequency of uterine contractions in asymptomatic twin pregnancies","volume":"95","author":"L A de Oliveira","year":"2016","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"01","key":"ref15","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1002\/uog.15668","article-title":"Cervical length at mid-gestation in screening for preterm birth in twin pregnancy","volume":"48","author":"G Pagani","year":"2016","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"02","key":"ref16","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1016\/j.siny.2016.01.005","article-title":"Risk assessment and management to prevent preterm birth","volume":"21","author":"B Koullali","year":"2016","journal-title":"Semin Fetal Neonatal Med"},{"issue":"03","key":"ref17","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1097\/GRF.0000000000000120","article-title":"Spontaneous preterm birth in multiples","volume":"58","author":"J R Biggio","year":"2015","journal-title":"Clin Obstet Gynecol"},{"issue":"05","key":"ref18","doi-asserted-by":"publisher","first-page":"1360","DOI":"10.1016\/j.ajog.2005.11.001","article-title":"Maternal characteristics and cervical length in the prediction of spontaneous early preterm delivery in twins","volume":"194","author":"M S To","year":"2006","journal-title":"Am J Obstet Gynecol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.1016\/S0140-6736(21)00217-8","article-title":"Evaluating Progestogens for Preventing Preterm birth International Collaborative (EPPPIC): meta-analysis of individual participant data from randomised controlled trials","volume":"397","author":"EPPPIC Group","year":"2021","journal-title":"Lancet"},{"issue":"04","key":"ref20","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1515\/jpm-2016-0102","article-title":"Impact of routine transvaginal ultrasound monitoring of cervical length in twins on administration of antenatal corticosteroids","volume":"45","author":"L Marcellin","year":"2017","journal-title":"J Perinat Med"},{"issue":"05","key":"ref21","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1515\/jpm.2010.088","article-title":"Two-stage transvaginal cervical length screening for preterm birth in twin pregnancies","volume":"38","author":"C Hofmeister","year":"2010","journal-title":"J Perinat Med"},{"issue":"02","key":"ref22","doi-asserted-by":"publisher","first-page":"277.e1","DOI":"10.1016\/j.ajog.2015.08.065","article-title":"Transvaginal cervical length scans to prevent prematurity in twins: a randomized controlled trial","volume":"214","author":"M C Gordon","year":"2016","journal-title":"Am J Obstet Gynecol"},{"issue":"01","key":"ref23","doi-asserted-by":"publisher","first-page":"CD007235","DOI":"10.1002\/14651858.CD007235.pub3","article-title":"Cervical assessment by ultrasound for preventing preterm delivery","author":"V Berghella","year":"2013","journal-title":"Cochrane Database Syst Rev"}],"container-title":["Revista Brasileira de Ginecologia e Obstetr\u00edcia \/ RBGO Gynecology and Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journalrbgo.org\/article\/the-use-of-mid-pregnancy-cervical-length-to-predict-preterm-birth-in-brazilian-asymptomatic-twin-gestations\/","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-1769467.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T20:52:28Z","timestamp":1721335948000},"score":1,"resource":{"primary":{"URL":"https:\/\/journalrbgo.org\/article\/the-use-of-mid-pregnancy-cervical-length-to-predict-preterm-birth-in-brazilian-asymptomatic-twin-gestations\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4]]},"references-count":23,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2023,5,24]]},"published-print":{"date-parts":[[2023,4]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-1769467","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0100-7203","1806-9339"],"issn-type":[{"type":"print","value":"0100-7203"},{"type":"electronic","value":"1806-9339"}],"subject":[],"published":{"date-parts":[[2023,4]]}}}