The predictive value of postoperative cervical length after emergent and urgent cervical cerclage as a predictive factor of preterm delivery

Abstract

ObjectiveThe aim of this study is to evaluate the value of the ultrasonographic cervical length after emergent and urgent cervical cerclage to prediction of preterm delivery in patients with incompetence of cervix. MethodsFifty-one women who underwen t emergent cervical cerclage and forty women who underwent urgent cervical cerclage were studied respectively. Receiver-operating characteristic (ROC) curve analysis, Pearson's partial correlation coeffi cient, and multiple logistic regression analysis were used for statistical analysis. ResultsThe mean gestational age at admission was 21.2 ± 2.3 weeks in emergent cerclage group and 21.8 ± 3.2 weeks in urgent cerclage group. Postoperative mean cervical length was 17.6 ± 8.6 mm in emergent group and 21.8 ± 8.7 mm in urgent group. The diagnostic indices of postoperative cervical length (cut-off value 16.5 mm in emergent cerclage, 23.2 mm in urgency cerclage) by ROC curve were sensitivity of 65%, specifi city of 45%, positive predictive value of 17%, and negative predictive value of 8% in emergent cerclage group and in urgent cerclage group, sensitivity of 85%, specifi city of 50%, positive predictive value of 17%, and negative predictive value of 16%. Multiple logistic regression analysis indicated that postoperative cervical length was not an independent predictor of preterm delivery after adjustment of confounding factors in emergent group (P=0.65) in urgent groups (P=0.77). ConclusionIn the both groups, the postoperative cervical length was longer than preoperative. However the postoperative cervical length is not a useful predictor of preterm delivery in patients with emergent and urgent cervical cerclage.