Avaliação da medida do comprimento do colo e da ausência do eco glandular endocervical para predição do parto pré-termo
Autor(a) principal: | |
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Data de Publicação: | 2004 |
Outros Autores: | , , |
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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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 |
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Revista Brasileira de Ginecologia e Obstetrícia |
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info:eu-repo/semantics/openAccess |
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openAccess |
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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 |
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reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
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Universidade Federal de São Paulo (UNIFESP) |
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UNIFESP |
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UNIFESP |
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Repositório Institucional da UNIFESP |
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Repositório Institucional da UNIFESP |
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Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
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biblioteca.csp@unifesp.br |
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1814268398251540480 |