Cervical Length Measurement for the Prediction of Preterm Birth in Symptomatic Women with a Twin Pregnancy : A Systematic Review and Meta-Analysis

Abstract EN

Objective.

The aim of this study was to assess whether cervical length measurement (CL) could predict preterm birth (PTB) in symptomatic women with a twin pregnancy.

Methods.

We searched MEDLINE and EMBASE to identify studies investigating the accuracy of CL measurement in predicting PTB in symptomatic women with a twin pregnancy.

We extracted data to construct two-by-two tables and used bivariate meta-analysis to generate point estimates of sensitivity and specificity.

Results.

Five studies (N=226) were included.

Variation in definition of PTB and cut-off points for CL was strong.

One study investigated delivery within seven days, demonstrating a sensitivity of 1.0 (95% CI: 0.83–1.0) and a specificity of 0.31 (95% CI 0.2–0.43) for a CL cutoff at 25 mm.

Three studies reported on predicting PTB < 37 weeks at a CL cutoff of 30 mm, with sROC point estimates of 0.76 (95% CI: 0.66 to 0.84) and 0.37 (95% CI: 0.21 to 0.56) for sensitivity and specificity, respectively.

For preterm birth <34 weeks, no pooled estimates could be estimated since only 2 studies with large heterogeneity were identified.

Conclusions.

There is limited evidence on the accuracy of cervical length measurement testing the prediction of preterm birth in symptomatic women with a twin pregnancy, especially on the most important outcome, that is, delivery within 7 days.