Prior cone biopsy: Prediction of preterm birth by cervical ultrasound

Vincenzo Berghella, Leonardo Pereira, Aileen Gariepy, Giuliana Simonazzi

Research output: Contribution to journalArticle

72 Scopus citations

Abstract

This study was undertaken to determine the predictive accuracy for preterm birth of transvaginal ultrasound (TVU) of the cervix in women with a prior cone biopsy. Pregnant patients with a history of cervical cone biopsy by cold knife, loop electrosurgical excision procedure (LEEP), or laser were monitored prospectively with TVU of the cervix between 16 and 24 weeks. The predictive value of TVU was evaluated by using less than 25 mm cervical length as criteria for the definition of a short cervix. The primary outcome was spontaneous preterm birth less than 35 weeks. Of 109 women with prior cone biopsy identified, 55 had LEEP, 45 cold knife, and 9 laser cone biopsies. Thirty (28%) had a short cervix, with 9 (30%) having spontaneous preterm birth less than 35 weeks. Seventy-nine (72%) did not have a short cervix, with 5 (6%) having spontaneous preterm birth less than 35 weeks. The sensitivity, specificity, and positive and negative predictive values for spontaneous preterm birth were 64%, 78%, 30%, and 94%, respectively (relative risk [RR] 4.7, 95% CI 1.6-15.3). TVU of the cervix is predictive of preterm birth in women with prior cone biopsy.

Original languageEnglish (US)
Pages (from-to)1393-1397
Number of pages5
JournalAmerican journal of obstetrics and gynecology
Volume191
Issue number4
DOIs
StatePublished - Oct 1 2004

Keywords

  • Cone biopsy
  • Laser cone
  • Loop electrosurgical excision procedure
  • Preterm birth
  • Transvaginal ultrasound

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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