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dc.contributor.authorAlvarez, RM
dc.contributor.authorBiliatis, I
dc.contributor.authorRockall, A
dc.contributor.authorPapadakou, E
dc.contributor.authorSohaib, SA
dc.contributor.authordeSouza, NM
dc.contributor.authorButler, J
dc.contributor.authorNobbenhuis, M
dc.contributor.authorBarton, D
dc.contributor.authorShepherd, JH
dc.contributor.authorInd, T
dc.date.accessioned2018-11-14T09:32:02Z
dc.date.issued2018-12
dc.identifier.citationBJOG : an international journal of obstetrics and gynaecology, 2018, 125 (13), pp. 1726 - 1733
dc.identifier.issn1470-0328
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/2927
dc.identifier.eissn1471-0528
dc.identifier.doi10.1111/1471-0528.15429
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.
dc.formatPrint-Electronic
dc.format.extent1726 - 1733
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://www.rioxx.net/licenses/under-embargo-all-rights-reserved
dc.subjectCervix Uteri
dc.subjectHumans
dc.subjectAbortion, Spontaneous
dc.subjectChorioamnionitis
dc.subjectFetal Membranes, Premature Rupture
dc.subjectPremature Birth
dc.subjectObserver Variation
dc.subjectMagnetic Resonance Imaging
dc.subjectOrgan Size
dc.subjectPregnancy Outcome
dc.subjectRisk Factors
dc.subjectReproducibility of Results
dc.subjectGestational Age
dc.subjectPregnancy
dc.subjectAdult
dc.subjectUterine Cervical Neoplasms
dc.subjectFemale
dc.subjectYoung Adult
dc.subjectFertility Preservation
dc.subjectTrachelectomy
dc.titleMRI measurement of residual cervical length after radical trachelectomy for cervical cancer and the risk of adverse pregnancy outcomes: a blinded imaging analysis.
dc.typeJournal Article
dcterms.dateAccepted2018-07-16
rioxxterms.versionofrecord10.1111/1471-0528.15429
rioxxterms.licenseref.urihttps://www.rioxx.net/licenses/under-embargo-all-rights-reserved
rioxxterms.licenseref.startdate2018-12
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfBJOG : an international journal of obstetrics and gynaecology
pubs.issue13
pubs.notesNot known
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.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-statusPublished
pubs.volume125
pubs.embargo.termsNot known
icr.researchteamMagnetic Resonanceen_US
dc.contributor.icrauthordeSouza, Nanditaen


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