Evaluación de la cervicometría e índice de bishop para diagnóstico de amenaza de parto prematuro. Servicio de alto riesgo obstétrico. Hospital de la Mujer, enero – marzo de 2019

Valle-Alarcón, María E

OBJETIVO:

determinar la validez y fiabilidad de la cervicometría y el índice de Bishop para diagnóstico de amenaza de parto prematuro MATERIAL Y MÉTODOS: estudio retrospectivo, cuantitativo, analítico para validación de un test diagnóstico.

MUESTRA:

el estudio incluye 185 embarazadas con feto único, de 22 a 37 semanas con estudio de cervicometría, en el periodo de enero a marzo del 2019.

RESULTADOS:

la frecuencia de parto prematuro en gestantes con diagnóstico de amenaza de parto prematuro fue de 27 % con mayor prevalencia en mujeres con 4 o más partos. La evaluación de la cervicometría para diagnóstico de amenaza de parto prematuro tiene una sensibilidad de 66.0%, especificidad 94.8%, Valor Predictivo (+) 82.5%, y Valor Predictivo (-) 88.3%. La evaluación del índice de Bishop una sensibilidad de 4.0%, especificidad 99.3%, Valor Predictivo (+) 66.7% y Valor Predictivo (-) 73.6%. El índice de concordancia entre la cervicometría y el índice de Bishop es ínfima de 0.017. El área bajo la curva ROC para cervicometría en relación con el diagnóstico final de parto prematuro fue de 0.905, con un mejor punto de corte 30.5 mm que corresponde a una sensibilidad de 90.4 % y una especificidad de 78.0 %.

CONCLUSIÓN:

se concluye que la concordancia entre la cervicometría y el índice de Bishop para diagnóstico de amenaza de parto prematuro es ínfima

In this study, the researchers aimed to determine the validity and reliability of cervicometry and the Bishop score for diagnosing threatened preterm labor in the high-risk obstetric service at the Hospital de la Mujer in La Paz during the period from January to March 2019. The study included pregnant women, and the results showed varying sensitivities and specificities for cervicometry and the Bishop score. The concordance between these two methods was found to be minimal.

OBJECTIVE:

to determine the validity and reliability of cervicometry and the Bishop score to diagnose threatened preterm labor.

MATERIAL AND METHODS:

retrospective, quantitative, and analytical study to validate a diagnostic test.

SAMPLE:

the study included 185 pregnant women with a single fetus, at gestational ages between 22 and 37 weeks, who underwent cervicometry assessment during the period from January to March 2019.

RESULTS:

the frequency of preterm labor in pregnant women diagnosed with threatened preterm labor was 27%, with higher prevalence in women with 4 or more previous deliveries. Cervicometry evaluation to diagnose threatened preterm labor showed a sensitivity of 66.0%, specificity of 94.8%, positive predictive value (+) of 82.5%, and negative predictive value (-) of 88.3%. Bishop score evaluation had a sensitivity of 4.0%, a specificity of 99.3%, a positive predictive value (+) of 66.7%, and a negative predictive value (-) of 73.6%. The concordance index between cervicometry and the Bishop score was minimal (0.017). The area under the ROC curve for cervicometry in relation to the final diagnosis of preterm labor was 0.905, with an optimal cutoff point of 30.5 mm, corresponding to a sensitivity of 90.4% and specificity of 78.0%.

CONCLUSION:

the concordance between cervicometry and the Bishop score to diagnose threatened preterm labor is minimal