Prematurity in multiple gestations

Identification of patients who are at low risk

Kimberly S. McMahon, Mark G. Neerhof, Elaine I. Haney, Hope A. Thomas, Richard K. Silver, Alan M Peaceman

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

OBJECTIVE: The purpose of this study was to evaluate a strategy for the identification of patients with multiple gestations who are at low risk for preterm delivery. STUDY DESIGN: A prospective observational study among patients with twin and triplet gestations. At 20 and 24 weeks of gestation, screening for bacterial vaginosis and fetal fibronectin was performed, followed by digital and sonographic assessment of the cervix. The treating physicians were blinded to test results. RESULTS: At the 24-week examination, specificities for delivery at >32 weeks of gestation for digital, examination (92.9%), fetal fibronectin level (93.9%), cervical length on sonographic scan (85.1%), and combined fetal fibronectin level and cervical length (81.3%) did not differ statistically. Negative predictive values for these tests were ≥95%. All tests performed better at 24 weeks of gestation than at 20 weeks of gestation. CONCLUSION: At 24 weeks of gestation, a normal digital examination, a negative fetal fibronectin level, a normal cervical length on sonographic scan, or the combination of a negative fetal fibronectin level and a normal cervical length each confer a similarly high likelihood of delivery at >32 weeks of gestation in women with multiple gestations.

Original languageEnglish (US)
Pages (from-to)1137-1141
Number of pages5
JournalAmerican Journal of Obstetrics and Gynecology
Volume186
Issue number6
DOIs
StatePublished - Jan 1 2002

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Pregnancy
Fibronectins
Predictive Value of Tests
Bacterial Vaginosis
Cervix Uteri
Observational Studies
Prospective Studies
Physicians

Keywords

  • Fetal fibronectin
  • Multiple gestations
  • Preterm delivery
  • Sonographic cervical length

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

McMahon, Kimberly S. ; Neerhof, Mark G. ; Haney, Elaine I. ; Thomas, Hope A. ; Silver, Richard K. ; Peaceman, Alan M. / Prematurity in multiple gestations : Identification of patients who are at low risk. In: American Journal of Obstetrics and Gynecology. 2002 ; Vol. 186, No. 6. pp. 1137-1141.
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abstract = "OBJECTIVE: The purpose of this study was to evaluate a strategy for the identification of patients with multiple gestations who are at low risk for preterm delivery. STUDY DESIGN: A prospective observational study among patients with twin and triplet gestations. At 20 and 24 weeks of gestation, screening for bacterial vaginosis and fetal fibronectin was performed, followed by digital and sonographic assessment of the cervix. The treating physicians were blinded to test results. RESULTS: At the 24-week examination, specificities for delivery at >32 weeks of gestation for digital, examination (92.9{\%}), fetal fibronectin level (93.9{\%}), cervical length on sonographic scan (85.1{\%}), and combined fetal fibronectin level and cervical length (81.3{\%}) did not differ statistically. Negative predictive values for these tests were ≥95{\%}. All tests performed better at 24 weeks of gestation than at 20 weeks of gestation. CONCLUSION: At 24 weeks of gestation, a normal digital examination, a negative fetal fibronectin level, a normal cervical length on sonographic scan, or the combination of a negative fetal fibronectin level and a normal cervical length each confer a similarly high likelihood of delivery at >32 weeks of gestation in women with multiple gestations.",
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Prematurity in multiple gestations : Identification of patients who are at low risk. / McMahon, Kimberly S.; Neerhof, Mark G.; Haney, Elaine I.; Thomas, Hope A.; Silver, Richard K.; Peaceman, Alan M.

In: American Journal of Obstetrics and Gynecology, Vol. 186, No. 6, 01.01.2002, p. 1137-1141.

Research output: Contribution to journalArticle

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AU - McMahon, Kimberly S.

AU - Neerhof, Mark G.

AU - Haney, Elaine I.

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AU - Silver, Richard K.

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N2 - OBJECTIVE: The purpose of this study was to evaluate a strategy for the identification of patients with multiple gestations who are at low risk for preterm delivery. STUDY DESIGN: A prospective observational study among patients with twin and triplet gestations. At 20 and 24 weeks of gestation, screening for bacterial vaginosis and fetal fibronectin was performed, followed by digital and sonographic assessment of the cervix. The treating physicians were blinded to test results. RESULTS: At the 24-week examination, specificities for delivery at >32 weeks of gestation for digital, examination (92.9%), fetal fibronectin level (93.9%), cervical length on sonographic scan (85.1%), and combined fetal fibronectin level and cervical length (81.3%) did not differ statistically. Negative predictive values for these tests were ≥95%. All tests performed better at 24 weeks of gestation than at 20 weeks of gestation. CONCLUSION: At 24 weeks of gestation, a normal digital examination, a negative fetal fibronectin level, a normal cervical length on sonographic scan, or the combination of a negative fetal fibronectin level and a normal cervical length each confer a similarly high likelihood of delivery at >32 weeks of gestation in women with multiple gestations.

AB - OBJECTIVE: The purpose of this study was to evaluate a strategy for the identification of patients with multiple gestations who are at low risk for preterm delivery. STUDY DESIGN: A prospective observational study among patients with twin and triplet gestations. At 20 and 24 weeks of gestation, screening for bacterial vaginosis and fetal fibronectin was performed, followed by digital and sonographic assessment of the cervix. The treating physicians were blinded to test results. RESULTS: At the 24-week examination, specificities for delivery at >32 weeks of gestation for digital, examination (92.9%), fetal fibronectin level (93.9%), cervical length on sonographic scan (85.1%), and combined fetal fibronectin level and cervical length (81.3%) did not differ statistically. Negative predictive values for these tests were ≥95%. All tests performed better at 24 weeks of gestation than at 20 weeks of gestation. CONCLUSION: At 24 weeks of gestation, a normal digital examination, a negative fetal fibronectin level, a normal cervical length on sonographic scan, or the combination of a negative fetal fibronectin level and a normal cervical length each confer a similarly high likelihood of delivery at >32 weeks of gestation in women with multiple gestations.

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