Índice de heterogeneidad cervical o longitud cervical en la predicción de parto pretérmino inminente en pacientes sintomáticas

Abstract

Objective: To compare the cervical heterogeneity index with cervical length for prediction of impending preterm delivery in symptomatic patients. Methods: This prospective study was conducted in women with single pregnancies between 24 and 35 weeks, with a clinical diagnosis of threatened preterm birth who attended the Central Hospital "Dr. Urquinaona", Maracaibo, Venezuela. At the time of diagnosis, the patients were evaluated using transvaginal ultrasound to establish the values of the cervical heterogeneity index and cervical length. The main outcome was impending delivery (within seven days after evaluation). Results: 326 patients were included, 75 women presented impending preterm delivery (group A) and, 251 patients were considered as controls (group B). No differences were found between the groups with maternal age, nulliparity, history of preterm delivery, history of smoking, and body mass index (p = ns). Group A patients had significantly lower cervical length and cervical heterogeneity index values compared to group B patients (p <0.0001). The cervical heterogeneity index showed an area under the curve value of 0.858 compared to the cervical length with a value of 0.985. The difference in the discrimination capacity between the areas under the curve of each test was significant (p <0.0001). Conclusion: The cervical heterogeneity index is not higher than the cervical length in predicting impending preterm delivery in symptomatic patients.