Valeur prédictive du risque d’accouchement prématuré par la mesure échographique de la longueur du col utérin en cas de grossesse gémellaire

Abstract

To assess ultrasonographic cervical length measurement in predicting preterm labor without premature rupture of the membrane in twin pregnancies. Retrospective study of 56 patients with preterm labor between 24+0 and 32+0 weeks. The judgment criteria was probability of delivery before 34 weeks in cases of spontaneous preterm labor before 32 weeks. The threshold of cervical length less than 20mm and 30mm respectively had a sensitivity of 42% and 94%, a specificity of 51% and 13%, a positive predictive value of 30% and 36% and a negative predictive value of 63% and 83% in predicting delivery before 34 weeks. Our results suggest that ultrasonographic measurement of cervical length is not a predictive of preterm delivery in twin pregnancies with preterm labor. However, the high negative predictive value allows to reassure the patient and to avoid hospitalization as well as tocolysis in cases where cervical length is superior or equal to 30mm.