. Author manuscript; available in PMC: 2016 Jan 31.

Published in final edited form as: Am J Obstet Gynecol. 2014 Jul 11;212(2):145–156. doi: 10.1016/j.ajog.2014.07.003

Table 3.

Measurements and performance of screening for precocious cervical ripening to predict singleton preterm delivery in large cohort studies, 1980–2014

Author, Published Year	Gestational weeks at initial assessment	Measurements (cm for CL)	Funneling Dilation %	Preterm (<wks)	Incidence of PTD %	Sensitivity %	Specificity %	PPV %	NPV %	ROC	LR+	LR−	Association
Papiernik et al., 1986²⁷	18	Dilation, Station, Length, Uterine contraction, Expanded lower segment	0.8–12.4 By ≤18, 24, 28, 31, 34, 36 wks	37	?								2.5–3.4 (vary by 0.8–4.3 weeks)
													0.9–2.9
													1.2–2.9
													0.6–1.9

Bouyer et al., 1986⁶¹	18	Score: short open cervix, contraction, parity, age	1.1–14	37	5.9^*	44–57^*	71–78^*				1.5–2.4^*	0.59–0.78^*	0.8–3.1/1.8–6.7^*
Bouyer et al., 1986⁶¹		Score: short open cervix, contraction, parity, age			5.5	56–64	73–78				2.1–2.8	0.47–0.58	0.9–2.7/1.6–3.5

Mortensen et al,1987⁶⁵	24	Modified Bishop score	4.0	37	1.5	33	88	4	97		2.8	0.76
		Dilation				11	97	6	99		3.6	0.92	8.3
		Effacement											3.1

Hartmann et al,1999⁷⁵	24–29	CL<2.0	6.0	37 or pPROM	8.3	13	93	15	92		1.9	0.94
		Dilation ≥1.0				8	99	38	92		8	0.93
		Cervical Score^{^}<2				20	93	21	92		2.9	0.86

Newman et al., 2008⁷⁷	22–24	T1: Bishop score ≥4	?	35	4.4	28	90.9	12		0.66	3.0	0.80
		Cervical score^{^}<1.5				13	97.9	21		0.61	6.4	0.88
		T2: Bishop score ≥5	?			32	93.0	14		0.68	4.6	0.73
		TVU CL<2.0				32	95	17	98	0.68	6.4	0.72
		TVU CF present				32	91	11	98		3.6	0.75
		Cervical score^{^}<1.5				36	95	20	98		7.4	0.67

Iams et al., 1996⁸	15–34	T1: Bishop≥4	6.4	35	4.3	28	91	12	97		3.0	0.80
		CL ≤2.5				37	92	18	97		4.8	0.68	6.19
		CF present				25	95	17	97		4.6	0.79
		T2: Bishop≥4	9.1			43	83	10	97		2.4	0.70
		CL ≤2.5				49	87	11	98		3.7	0.58	9.57
		CF present				33	92	17	98		3.9	0.34

Hasegawa et al,1996⁶¹	15–34	CL ≤2.7	7.8	36	3.3			10^*/2					4.86 (1.85–12.72)^*
Hasegawa et al,1996⁶¹		Open internal os. Funneling index						7^*/11					6.00 (1.65–21.71)

Taipale & Hiilesmaa, 1998⁶³	18–22	CL ≤2.9	0.7	35	0.8	19	97	6			6.3	0.84	8
		Dilation ≥0.5		37	2.4	16	99	20			16	0.85	28
		Either				29	97	7			9.7	0.73	11

To et al., 2001⁶⁴	22–24	CL	4	33	0.9								24.9
To et al., 2001⁶⁴		Internal os. ≥0.5											1.8

de Carvalho et al, 2005⁷⁶	21–24	CL ≤2	1.5	34	3.4	7
de Carvalho et al, 2005⁷⁶		Add CF present				34

Leung et al, 2005⁶²	18–22	CL ≤2.7	6.3 width 6.4 depth 4.3	34	0.7	37	96	6	100		9.8	0.66
		CF				32	94	3	100		5.2	0.73
		Both				26	99	15	100		26	0.74
		Either				42	91	3	100		4.7	0.64

Parra-Saavedra et al., 2011⁸⁰	5–36	Consistency index	Excluded	34	2.1	64	98	47	99	0.94	39.7
Parra-Saavedra et al., 2011⁸⁰		CL				9	98	9	98		4.3

Note: The bolded composite measures had better predictive performance than cervical length alone. T1 and T2, assessments at two time points.

for nulliparous women, other values in the same cell for parous women;

^{^}

Cervical Score= Cervical length (cm) – Cervical dilation (cm). CL: cervical length; CF: cervical funneling; DE: digital examination; TVU: transvaginal ultrasonography; PTD, preterm delivery; wks: weeks; Ibid: the same as above; ROC: receiver operating characteristic curves; PPV: positive predictive value; NPV: negative predictive value; LR: likelihood ratio, calculated results based on original values in papers before being rounded.