Elnasr, I., Fahmy, M., Hamza, H., Ammar, H. (2020). Transvaginal nUltrasound Measurement of Lower Uterine Segment Myometrial Thickness for the Prediction of Preterm Labor in Twins Gestations. Observational Study. The Egyptian Journal of Hospital Medicine, 81(2), 1365-1372. doi: 10.21608/ejhm.2020.114430
Ibrahim Saif Elnasr; Mohamed Fahmy; Haitham Hamza; Hesham Ammar. "Transvaginal nUltrasound Measurement of Lower Uterine Segment Myometrial Thickness for the Prediction of Preterm Labor in Twins Gestations. Observational Study". The Egyptian Journal of Hospital Medicine, 81, 2, 2020, 1365-1372. doi: 10.21608/ejhm.2020.114430
Elnasr, I., Fahmy, M., Hamza, H., Ammar, H. (2020). 'Transvaginal nUltrasound Measurement of Lower Uterine Segment Myometrial Thickness for the Prediction of Preterm Labor in Twins Gestations. Observational Study', The Egyptian Journal of Hospital Medicine, 81(2), pp. 1365-1372. doi: 10.21608/ejhm.2020.114430
Elnasr, I., Fahmy, M., Hamza, H., Ammar, H. Transvaginal nUltrasound Measurement of Lower Uterine Segment Myometrial Thickness for the Prediction of Preterm Labor in Twins Gestations. Observational Study. The Egyptian Journal of Hospital Medicine, 2020; 81(2): 1365-1372. doi: 10.21608/ejhm.2020.114430
Transvaginal nUltrasound Measurement of Lower Uterine Segment Myometrial Thickness for the Prediction of Preterm Labor in Twins Gestations. Observational Study
Obstetrics and Gynecology Departments, Faculty of Medicine, Menoufia University Menoufia, Egypt
Abstract
Background: Transvaginal ultrasound evaluation of cervical length considered a good predictor of PTL and recently lower uterine segment myometrial thickness had been used for this purpose. Objectives: Evaluating the efficacy and validity of transvaginal ultrasound measurement of lower uterine segment myometrial thickness (LUS-MT) in prediction of preterm delivery (PTL) in twins pregnancies. Patients and Methods: This is an observational prospective cohort study where ninety sex (96) twins pregnant women were enrolled. LUS-MT and CL were measured by transvaginal ultrasound between 16-24 gestational weeks. All patients were scheduled for routine antenatal care till delivery and divided in two groups: preterm group and full-term group. Results: 58 patients delivered at full term and 38 patients had preterm delivery. Among patients who had preterm delivery, 25 patients (56.8%) had LUS-MT <4.26 and 2 patients (3.8%) only had LUS-MT ≥4. among patients who delivered at full term, 50 patients (96.2%) had LUS-MT ≥4.26 and 19 patients (43.2%) had LUS-MT <4.26. The best cutoff value for LUS was 4.26 mm with area under the ROC curve (AUC) 0.917, sensitivity 92.1 %, specificity 86.2%, PPV 81.3%, NPV 94.3% and Accuracy 92.1 %. Conclusion: Transvaginal ultrasound measurement of LUS-MT is an effective, precise, applicable and safe procedure in predicting the preterm labor in twins gestation with high validity than cervical length. Use of lower uterine wall as a substitution of CL measurement in order to predict population at risk of preterm labor needs to be investigated.