To evaluate the accuracy of a single sonographic measurement of cervical length early in the third trimester as a predictor of preterm delivery. A total of 771 women attending the antenatal clinic at the Maharaj Nakorn Chiang Mai Hospital between January 1, 1990, and November 30, 1993, with singleton gestations, cervical competence, accurate dates of last menstrual period, and gestational ages between 28-30 weeks, were recruited into the study. Forty-one were excluded, ten because of induced preterm delivery, 24 because of measurement problems, and seven because they were lost to follow-up. We analyzed the remaining 730 women. Ninety-one (12.5%) women ended with preterm births and the remaining 639 (87.5%) delivered at term. The mean (+/- standard deviation) cervical lengths of the term and preterm groups were statistically significantly different at 37 +/- 5 and 34 +/- 6 mm, respectively (P < .001). The likelihood ratio of cervical length at various cutoff points was calculated. The appropriate cutoff point based on the receiver operating characteristic curve (35 mm) was associated with a significantly increased likelihood of preterm delivery (20 versus 7%) and was detected in two-thirds of preterm births. This cutoff point gave a sensitivity and specificity of 65.9 +/- 5.1% (95% confidence interval [CI]) and 62.4 +/- 5.2% (95% CI), respectively. A single transvaginal sonographic measurement of cervical length at 28-30 gestational weeks can be used to predict the risk of preterm delivery, using a cutoff point of 35 mm, but its cost-effectiveness should be assessed further.

The objective was to determine the strength of relationship between maternal free beta human chorionic gonadotropin (β-hCG) concentrations and rates of adverse pregnancy outcomes. Consecutive records of the database of our Down screening project were assessed for free β-hCG levels and pregnancy outcomes. Pregnancies with foetal chromosomal or structural anomalies and those with underlying disease were excluded. Free β-hCG levels of < 0.5, > 0.5 and < 2.0, and ≥ 2.0 MoM were categorised as low, normal and high, respectively. Of 17,082 screened women, 13,620 were available for analysis. In the first trimester (n = 8150), low β-hCG levels significantly increased risk for intrauterine growth restriction (IUGR), preterm birth, low birth weight (LBW) and low Apgar score with relative risk of 1.66, 1.43, 1.83 and 2.89; whereas high β-hCG group had a significant decreased risk of preterm birth and GDM with relative risk of 0.73 and 0.62. In the second trimester (n = 5470), both low and high β-hCG groups had significant increased risks of the most common adverse outcomes, i.e. spontaneous abortion, IUGR and preterm birth. In conclusion, abnormally low (< 0.5MoM) or high (> 2.0 MoM) free β-hCG levels are generally associated with an increased risk of adverse pregnancy outcomes. Nevertheless, high free β-hCG levels in the first trimester may possibly decrease risk of preterm delivery and GDM.

Objectives: To establish normative reference ranges of fetal cardiac dimensions derived from volume datasets acquired using spatiotemporal image correlation with M‐mode display (cardio‐STIC‐M).Methods: A cross‐sectional study was undertaken on singleton pregnancies with normal fetuses and accurate gestational ages. Cardio‐STIC volume datasets were acquired by experienced operators using a high‐resolution ultrasound machine; these were maneuvered to obtain a four chamber‐view with exactly horizontal interventricular septum (IVS). Cardiac dimensions were measured in STIC‐M‐mode using 4D View software.Results: A total of 657 measurements, at a rate of between 15 and 37 per week, were obtained. Normal reference ranges for biventricular outer diameter, left and right ventricular inner diameter, left and right ventricular wall thickness, IVS thickness, left to right ventricular diameter ratio and left and right ventricular shortening fractions were constructed based on best‐fit equations as a function of gestational age, fetal head circumference and biparietal diameter. Thirty‐four volume datasets of abnormal fetal hearts were also separately assessed, many of which showed abnormal cardiac dimensions.Conclusions: This is the first report on normal ranges of fetal cardiac dimensions constructed using the new cardio‐STIC‐M technology. Preliminary evaluation suggests that these reference ranges may be a useful tool in the assessment of fetal cardiac abnormalities. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.