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dc.contributor.authorAlvarez, RMen_US
dc.contributor.authorBiliatis, Ien_US
dc.contributor.authorRockall, Aen_US
dc.contributor.authorPapadakou, Een_US
dc.contributor.authorSohaib, SAen_US
dc.contributor.authordeSouza, NMen_US
dc.contributor.authorButler, Jen_US
dc.contributor.authorNobbenhuis, Men_US
dc.contributor.authorBarton, Den_US
dc.contributor.authorShepherd, JHen_US
dc.contributor.authorInd, Ten_US
dc.coverage.spatialEnglanden_US
dc.date.accessioned2018-11-14T09:32:02Z
dc.date.issued2018-12en_US
dc.identifierhttps://www.ncbi.nlm.nih.gov/pubmed/30099822en_US
dc.identifier.citationBJOG, 2018, 125 (13), pp. 1726 - 1733en_US
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/2927
dc.identifier.eissn1471-0528en_US
dc.identifier.doi10.1111/1471-0528.15429en_US
dc.description.abstractOBJECTIVE: To determine the association between the residual cervix measured on postoperative MRI after radical vaginal trachelectomy (RVT) and adverse obstetrical outcomes. DESIGN: Observational study. SETTING: Referral Cancer centre. POPULATION: Women who conceived after RVT for cervical cancer at the Royal Marsden Hospital, London, between 1995 and 2015. METHODS: Postoperative MRI scans were analysed by three researchers. The agreement between researchers was assessed by Pearson's correlation coefficient and Bland-Altman plot. Patients were divided into two groups (<10 and ≥10 mm residual cervix) for the analysis of adverse obstetrical outcomes. MAIN OUTCOME MEASURES: Late miscarriage, premature delivery, premature rupture of membranes (PROM) and chorioamnionitis. RESULTS: Thirty-one MRI scans were available; 29 of these women had a pregnancy that progressed beyond the first trimester. There was a strong reproducibility of the measurement of residual cervix (P < 0.001). Nineteen women (65.5%) had <10 mm residual cervix and 10 (34.5%) had ≥10 mm. Among women with <10 mm residual cervix, seven (36.8%) experienced PROM and ten (66.7%) had a preterm birth; No women with ≥10 mm residual cervix had PROM and two (22.2%) had a preterm birth (P = 0.028 and P = 0.035, respectively). Overall, there were nine (16.7%) first-trimester miscarriages, six (11.1%) late fetal losses, 12 (31.6%) preterm births and 36 (66.7%) live births. After a mean follow up of 78.1 months, 36 women were disease-free and one woman had died. CONCLUSIONS: MRI measurements of the residual cervix are reproducible between observers. The incidence of PROM and premature delivery is higher when the residual cervix after RVT is <10 mm. TWEETABLE ABSTRACT: The risk of prematurity after RVT can be predicted from measurements of residual cervical length on postoperative MRI scan.en_US
dc.format.extent1726 - 1733en_US
dc.languageengen_US
dc.language.isoengen_US
dc.rights.urihttp://www.rioxx.net/licenses/under-embargo-all-rights-reserveden_US
dc.subjectCervical canceren_US
dc.subjectfertility-sparing treatmenten_US
dc.subjectobstetrical complicationsen_US
dc.subjectpregnancy outcomesen_US
dc.subjecttrachelectomyen_US
dc.titleMRI measurement of residual cervical length after radical trachelectomy for cervical cancer and the risk of adverse pregnancy outcomes: a blinded imaging analysis.en_US
dc.typeJournal Article
dcterms.dateAccepted2018-07-16en_US
rioxxterms.versionofrecord10.1111/1471-0528.15429en_US
rioxxterms.licenseref.startdate2018-12en_US
rioxxterms.typeJournal Article/Reviewen_US
dc.relation.isPartOfBJOGen_US
pubs.issue13en_US
pubs.notesNot knownen_US
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Magnetic Resonance
pubs.publication-statusPublisheden_US
pubs.volume125en_US
pubs.embargo.termsNot knownen_US
icr.researchteamMagnetic Resonanceen_US
dc.contributor.icrauthordeSouza, Nanditaen_US


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