Avaliação da medida do comprimento do colo e da ausência do eco glandular endocervical para predição do parto pré-termo

Detalhes bibliográficos
Autor(a) principal: Pires, Claudio Rodrigues [UNIFESP]
Data de Publicação: 2004
Outros Autores: Moron, Antonio Fernandes [UNIFESP], Mattar, Rosiane [UNIFESP], Kulay Júnior, Luiz [UNIFESP]
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Institucional da UNIFESP
Texto Completo: http://dx.doi.org/10.1590/S0100-72032004000300004
http://repositorio.unifesp.br/handle/11600/2062
Resumo: PURPOSE: to verify the prevalence of two sonographic findings, the cervical gland area (CGA) feature and the cervical length of less than 20 mm, and to compare these with the risk for premature delivery in pregnant women between 21 and 24 weeks' gestation. METHOD: this was a prospective, cross-sectional study in which 361 women were consecutively examined by transvaginal ultrasonography. Müllerian or other malformations, multiple gestations, fetal death, olygo- or polyhydramnios, marginal placenta previa, and conization, cerclage, amputation or other surgical procedures in the cervix, prior to or during pregnancy, were exclusion criteria. After the abdominal ultrasonographic morphological examination, we used transvaginal ultrasonography to measure the cervical length and to observe the presence of hyper- or hypoechoic area next to the endocervical canal, a feature characteristic of endocervical epithelium glands which is called CGA (cervical gland area). Qualitative variables are expressed as absolute and relative frequency. Quantitative variables are expressed as mean, median, standard deviation, minimum, and maximum values. Association between qualitative variables was detected by the c² test or by the Fisher exact test. For each variable, the relative risk and the 95% confidence interval (CI) were calculated. Logistic regression analysis was used to calculate the predictive values for premature delivery. Significance level was 95% (alpha = 5%), with descriptive (p) values equal or lower than 0.05 considered significant. RESULTS: spontaneous preterm delivery occurred in 5.0% of the patients. Cervical length was up to 20 mm in 3.3% of all studied patients and in 27.8% of those who delivered spontaneously before the end of the pregnancy. Absence of the CGA was detected in 2.8% of all patients and in 44.4% of the women who eventually developed spontaneous preterm labor. There was a statistically significant association of absence of CGA with short cervical length (p<0.001). Absence of CGA was strongly associated with spontaneous preterm delivery (relative risk of 28.57, 95% CI 14.40-56.68). CONCLUSION: the absent CGA feature is a new morphological ultrasonographic parameter that is useful in the prediction of spontaneous preterm delivery in single gestations. Our results show that the parameter can be used as an indicator of risk for premature delivery, to be confirmed by future research.
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spelling Avaliação da medida do comprimento do colo e da ausência do eco glandular endocervical para predição do parto pré-termoEvaluation of risk for preterm delivery by measurement of uterine cervix and cervical gland areaCervix incompetenceCervix uteriPremature laborUltrasonographyUltrasonicsColo uterinoParto pré-termoComprimento do coloEco glandular endocervicalPURPOSE: to verify the prevalence of two sonographic findings, the cervical gland area (CGA) feature and the cervical length of less than 20 mm, and to compare these with the risk for premature delivery in pregnant women between 21 and 24 weeks' gestation. METHOD: this was a prospective, cross-sectional study in which 361 women were consecutively examined by transvaginal ultrasonography. Müllerian or other malformations, multiple gestations, fetal death, olygo- or polyhydramnios, marginal placenta previa, and conization, cerclage, amputation or other surgical procedures in the cervix, prior to or during pregnancy, were exclusion criteria. After the abdominal ultrasonographic morphological examination, we used transvaginal ultrasonography to measure the cervical length and to observe the presence of hyper- or hypoechoic area next to the endocervical canal, a feature characteristic of endocervical epithelium glands which is called CGA (cervical gland area). Qualitative variables are expressed as absolute and relative frequency. Quantitative variables are expressed as mean, median, standard deviation, minimum, and maximum values. Association between qualitative variables was detected by the c² test or by the Fisher exact test. For each variable, the relative risk and the 95% confidence interval (CI) were calculated. Logistic regression analysis was used to calculate the predictive values for premature delivery. Significance level was 95% (alpha = 5%), with descriptive (p) values equal or lower than 0.05 considered significant. RESULTS: spontaneous preterm delivery occurred in 5.0% of the patients. Cervical length was up to 20 mm in 3.3% of all studied patients and in 27.8% of those who delivered spontaneously before the end of the pregnancy. Absence of the CGA was detected in 2.8% of all patients and in 44.4% of the women who eventually developed spontaneous preterm labor. There was a statistically significant association of absence of CGA with short cervical length (p<0.001). Absence of CGA was strongly associated with spontaneous preterm delivery (relative risk of 28.57, 95% CI 14.40-56.68). CONCLUSION: the absent CGA feature is a new morphological ultrasonographic parameter that is useful in the prediction of spontaneous preterm delivery in single gestations. Our results show that the parameter can be used as an indicator of risk for premature delivery, to be confirmed by future research.OBJETIVO: verificar a prevalência do sinal eco glandular endocervical (EGE) e o comprimento cervical menor ou igual a 20 mm em gestantes entre a 21ª e a 24ª semana e comparar estes sinais ecográficos como fatores indicadores de parto pré-termo espontâneo. MÉTODOS: estudo prospectivo transversal no qual foram incluídas 361 gestantes da população geral, para realização de exame ultra-sonografico em idade gestacional entre a 21ª a 24ª semana. Os critérios de exclusão do estudo foram malformações müllerianas, gestações múltiplas, malformações fetais, óbito fetal, alterações da quantidade de líquido amniótico, placenta com inserção segmentar, antecedentes de cirurgia no colo uterino (conização, amputação, cerclagem) e procedimentos cirúrgicos durante a gestação. Após a realização do exame ultra-sonográfico obstétrico morfológico efetuado por via abdominal, seguiu-se o exame ecográfico por via vaginal para observação de uma faixa hipoecóica ou hiperecóica adjacente ao canal endocervical correpondente às glândulas do epitélio endocervical (EGE) e mensuração do comprimento cervical. As variáveis qualitativas são representadas por freqüência absoluta e relativa, ao passo que as variáveis quantitativas, por média, desvio-padrão, mediana e valores mínimo e máximo. A associação entre as variáveis qualitativas foi avaliada pelo teste c² ou teste exato de Fisher. Para cada variável estudada, foi calculado o risco relativo seguido do intervalo com 95% de confiança. A técnica de análise de regressão logística univariada foi utilizada para verificar, entre as variáveis estudadas, quais foram indicativas de parto pré-termo espontâneo. O nível de significância adotado foi de 95% (alfa = 5%) e descritivos (p) iguais ou inferiores a 0,05 foram considerados significantes. RESULTADOS: a incidência do parto pré-termo espontâneo foi de 5,0%. O comprimento do colo uterino revelou-se igual ou inferior a 20 mm em 3,3% da população estudada e em 27,8% das pacientes que apresentaram parto pré-termo espontâneo. A ausência do EGE foi detectada em 2,8% das pacientes estudadas e em 44,4% das pacientes que evoluíram para parto pré-termo espontâneo. A associação entre ausência do EGE e presença do colo curto revelou-se estatisticamente significante (p<0,001). A ausência do EGE teve forte associação com parto pré-termo espontâneo e risco relativo de 28,57, com intervalo de confiança (IC 95%) 14,40-56,68. A medida do comprimento cervical inferior a 20 mm também apresentou associação com parto pré-termo espontâneo (p<0,001), com risco relativo de 11,27 e IC 95% de 4,79-26,53. CONCLUSÃO: a não visualização do EGE endocervical constitui parâmetro morfológico ultra-sonográfico novo e útil na predição do parto pré-termo espontâneo nas gestações únicas da população geral. Os resultados deste trabalho indicam uma tendência clara da marcante importância da ausência do EGE como indicador do risco para parto pré-termo espontâneo, a ser confirmada em pesquisas multicêntricas futuras.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de ObstetríciaUNIFESP, EPM, Depto. de ObstetríciaSciELOFederação Brasileira das Sociedades de Ginecologia e ObstetríciaUniversidade Federal de São Paulo (UNIFESP)Pires, Claudio Rodrigues [UNIFESP]Moron, Antonio Fernandes [UNIFESP]Mattar, Rosiane [UNIFESP]Kulay Júnior, Luiz [UNIFESP]2015-06-14T13:30:21Z2015-06-14T13:30:21Z2004-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion193-200application/pdfhttp://dx.doi.org/10.1590/S0100-72032004000300004Revista Brasileira de Ginecologia e Obstetrícia. Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, v. 26, n. 3, p. 193-200, 2004.10.1590/S0100-72032004000300004S0100-72032004000300004.pdf0100-7203S0100-72032004000300004http://repositorio.unifesp.br/handle/11600/2062porRevista Brasileira de Ginecologia e Obstetríciainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-07-28T06:51:51Zoai:repositorio.unifesp.br/:11600/2062Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-07-28T06:51:51Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.none.fl_str_mv Avaliação da medida do comprimento do colo e da ausência do eco glandular endocervical para predição do parto pré-termo
Evaluation of risk for preterm delivery by measurement of uterine cervix and cervical gland area
title Avaliação da medida do comprimento do colo e da ausência do eco glandular endocervical para predição do parto pré-termo
spellingShingle Avaliação da medida do comprimento do colo e da ausência do eco glandular endocervical para predição do parto pré-termo
Pires, Claudio Rodrigues [UNIFESP]
Cervix incompetence
Cervix uteri
Premature labor
Ultrasonography
Ultrasonics
Colo uterino
Parto pré-termo
Comprimento do colo
Eco glandular endocervical
title_short Avaliação da medida do comprimento do colo e da ausência do eco glandular endocervical para predição do parto pré-termo
title_full Avaliação da medida do comprimento do colo e da ausência do eco glandular endocervical para predição do parto pré-termo
title_fullStr Avaliação da medida do comprimento do colo e da ausência do eco glandular endocervical para predição do parto pré-termo
title_full_unstemmed Avaliação da medida do comprimento do colo e da ausência do eco glandular endocervical para predição do parto pré-termo
title_sort Avaliação da medida do comprimento do colo e da ausência do eco glandular endocervical para predição do parto pré-termo
author Pires, Claudio Rodrigues [UNIFESP]
author_facet Pires, Claudio Rodrigues [UNIFESP]
Moron, Antonio Fernandes [UNIFESP]
Mattar, Rosiane [UNIFESP]
Kulay Júnior, Luiz [UNIFESP]
author_role author
author2 Moron, Antonio Fernandes [UNIFESP]
Mattar, Rosiane [UNIFESP]
Kulay Júnior, Luiz [UNIFESP]
author2_role author
author
author
dc.contributor.none.fl_str_mv Universidade Federal de São Paulo (UNIFESP)
dc.contributor.author.fl_str_mv Pires, Claudio Rodrigues [UNIFESP]
Moron, Antonio Fernandes [UNIFESP]
Mattar, Rosiane [UNIFESP]
Kulay Júnior, Luiz [UNIFESP]
dc.subject.por.fl_str_mv Cervix incompetence
Cervix uteri
Premature labor
Ultrasonography
Ultrasonics
Colo uterino
Parto pré-termo
Comprimento do colo
Eco glandular endocervical
topic Cervix incompetence
Cervix uteri
Premature labor
Ultrasonography
Ultrasonics
Colo uterino
Parto pré-termo
Comprimento do colo
Eco glandular endocervical
description PURPOSE: to verify the prevalence of two sonographic findings, the cervical gland area (CGA) feature and the cervical length of less than 20 mm, and to compare these with the risk for premature delivery in pregnant women between 21 and 24 weeks' gestation. METHOD: this was a prospective, cross-sectional study in which 361 women were consecutively examined by transvaginal ultrasonography. Müllerian or other malformations, multiple gestations, fetal death, olygo- or polyhydramnios, marginal placenta previa, and conization, cerclage, amputation or other surgical procedures in the cervix, prior to or during pregnancy, were exclusion criteria. After the abdominal ultrasonographic morphological examination, we used transvaginal ultrasonography to measure the cervical length and to observe the presence of hyper- or hypoechoic area next to the endocervical canal, a feature characteristic of endocervical epithelium glands which is called CGA (cervical gland area). Qualitative variables are expressed as absolute and relative frequency. Quantitative variables are expressed as mean, median, standard deviation, minimum, and maximum values. Association between qualitative variables was detected by the c² test or by the Fisher exact test. For each variable, the relative risk and the 95% confidence interval (CI) were calculated. Logistic regression analysis was used to calculate the predictive values for premature delivery. Significance level was 95% (alpha = 5%), with descriptive (p) values equal or lower than 0.05 considered significant. RESULTS: spontaneous preterm delivery occurred in 5.0% of the patients. Cervical length was up to 20 mm in 3.3% of all studied patients and in 27.8% of those who delivered spontaneously before the end of the pregnancy. Absence of the CGA was detected in 2.8% of all patients and in 44.4% of the women who eventually developed spontaneous preterm labor. There was a statistically significant association of absence of CGA with short cervical length (p<0.001). Absence of CGA was strongly associated with spontaneous preterm delivery (relative risk of 28.57, 95% CI 14.40-56.68). CONCLUSION: the absent CGA feature is a new morphological ultrasonographic parameter that is useful in the prediction of spontaneous preterm delivery in single gestations. Our results show that the parameter can be used as an indicator of risk for premature delivery, to be confirmed by future research.
publishDate 2004
dc.date.none.fl_str_mv 2004-04-01
2015-06-14T13:30:21Z
2015-06-14T13:30:21Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1590/S0100-72032004000300004
Revista Brasileira de Ginecologia e Obstetrícia. Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, v. 26, n. 3, p. 193-200, 2004.
10.1590/S0100-72032004000300004
S0100-72032004000300004.pdf
0100-7203
S0100-72032004000300004
http://repositorio.unifesp.br/handle/11600/2062
url http://dx.doi.org/10.1590/S0100-72032004000300004
http://repositorio.unifesp.br/handle/11600/2062
identifier_str_mv Revista Brasileira de Ginecologia e Obstetrícia. Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, v. 26, n. 3, p. 193-200, 2004.
10.1590/S0100-72032004000300004
S0100-72032004000300004.pdf
0100-7203
S0100-72032004000300004
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv Revista Brasileira de Ginecologia e Obstetrícia
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 193-200
application/pdf
dc.publisher.none.fl_str_mv Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
publisher.none.fl_str_mv Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
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