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Master Thesis

Seuil de la mesure échographique du col utérin dans la prise en charge des menaces d'accouchement prématuré

Abstract : Objective: Preterm labor diagnosis is based on ultrasound measurement of cervical length. This study aimed to analyze the pertinency of different thresholds of cervical length in predicting delivery within 7 days after antenatal corticosteroids injection (effectiveness period of corticosteroids) to optimize its moment of administration. Methods: Our study is a monocentric retrospective study conducted in the Centre Hospitalier Intercommunal de Poissy within January 2018 and January 2020. Included patients presented a preterm labor between 24 et 34 weeks of gestation on a singleton pregnancy, without associated rupture of membranes and had received a dose of antenatal corticosteroids. The primary endpoint was the rate of delivery within 7 days after the corticosteroid’s injection. We therefore calculated the diagnostic performances of the cervical length ultrasound measurement and determined an optimal threshold of 10 mm. We then compared it to 15 mm and 25 mm through their diagnostic performances, the analysis of false positive’s and false negative’s proportion. Results: Our population consisted of 115 patients with a median cervical length of 11 mm and a median cure-to-delivery lapse of time of 20 days. 72 patients gave birth after 7 days (62.6%, IC95% 58.3-66.9) of which more than half continued pregnancy until term (52.8% ; IC95% 47.7-57.9). The optimal threshold was 10 mm and was more specific than 15 mm or 25 mm cutoffs. According to this threshold, false postive’s rates were 21.7% (IC95% 17.9-25.6) versus 62.6% (95% CI 54.0-71.2) for 25 mm. Rates of false negatives were 10.4% (IC95% 5.6-15.3) versus 0. Conclusion: A threshold of 10 mm, could considerably reduce the proportion of patients unnecessarily treated.
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Submitted on : Tuesday, March 22, 2022 - 2:07:48 PM
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DE GENNARO_Valentina_2021.pdf
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Valentina de Gennaro. Seuil de la mesure échographique du col utérin dans la prise en charge des menaces d'accouchement prématuré. Gynécologie et obstétrique. 2021. ⟨dumas-03616335⟩



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