Cervical length sonographic measurements among non-standardized physicians compared to standardized physicians for the detection of risk of preterm delivery in women of the opportune screening network in Guanajuato

Cervical length sonographic measurements among non-standardized physicians compared to standardized physicians for the detection of risk of preterm delivery in women of the opportune screening network in Guanajuato

H. Ayon (1), M. Bermudez (2), E. Lara (3), S. Briones (3)

(1) CETO extended screening area, student of master in clinical investigation Universidad de Guanajuato Mexico; (2) CETO coordination, perinatal medicine, Mexico; (3) Department of Medicine and Nutrition, University of Guanajuato, Mexico; (3) Department of Medicine and Nutrition, University of Guanajuato.

Background:
WHO defined as preterm, babies which are born before 37 weeks of gestation; this has family, social impact. Combining sonographic cervical measurements and maternal history, risk for preterm birth can be predicted before 28 SDG with a sensitivity of 81%, and administer preventive treatment to avoid preterm birth or avoid unnecessary management. There are programs that trains and certifies medical staff to perform sonographic screenings, but in our region, the attachment to standard has not been determined. Objective: To measure the concordance between sonographic measurements of cervical length made by non-standardized physicians compared to standardized physicians in order to detect the risk of preterm delivery in pregnant patients.

Methods:
A Cross-sectional non probabilistic comparison of concordance in sonographic cervical length of consecutive cases was conducted in 1145 women with pregnancy from the state of Guanajuato during the sonographic screening in the 1st trimester at the State Center for timely screening (CETO).

Results:
A sample of 1145 patients with 91 losses; mean of maternal age 26.3 years; nutritional status with normal weight in 35.3%, over weight and obesity in 61.7%, history of abortion in 23.2% and 9.3% had preterm birth history; gestational age was averaged in 13 weeks, cervical length 33.2mm; Cohen’s Kappa test was performed to evaluate the concordance between seven trained and certified sonographers, the personel with the highest Kappa were those who had undergone a process of standardization, this is showed in table 2.

Conclusions:
There was an improvement in the degree of inter observer agreement when the staff is subject to standardization processes.

Ethical statement:
Approved by the research ethics committee of the Hospital de Especialidades Materno Infantil de León with folio 130-2018.

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