Associating measuring cervical length with preterm birth amongst hospitalised women diagnosed with threatened preterm labour
DOI:
https://doi.org/10.18597/rcog.544Keywords:
premature labour, cervix, uterine-ultrasonographyAbstract
Objective: assessing the accuracy of measuring cervical length when predicting preterm birth amongst a population of hospitalised women diagnosed with threatened preterm labour (initial preterm labour), single pregnancy and intact foetal membranes.
Method: a prospective cohort study was carried out of the obstetrics services of three institutions from the metropolitan area of Medelín between January and June 2004. The sample size was estimated with a 0.05 alpha, 80% power, 2.5% preterm birth incidence in the unexposed group and 6.0 relative risk. There were 76 patients in two groups (152 patients in all). The first group of 76 patients had a positive cervical length (less than 30 mm cervical length). The second group had a negative cervical length (cervical length of more than 30 mm).
Results: 156 hospital charts were reviewed; 22 were excluded because they did not contain information regarding final gestation outcome. 53 out of the remaining 134 charts presented a positive cervical length (less than 30 mm) and 81 had negative cervical length (more than 30 mm). Bivariable analysis of the main final outcome (preterm birth) revealed that the only statistically significant outcomes were having a cervical length of less than 30 mm and vaginal infection (p < 0.05). The only statistically significant outcome (when using multivariable analysis) was having a cervical length of less than 30 mm (11.1 OR, 4.55–27.05 95% CI).
Conclusions: cervical length of less than 30 mm was a risk predictor in the study population for preterm labour in patients diagnosed with initial preterm labour.
Author Biographies
Antonio González
Jorge Hernando Donado
David Felipe Agudelo
Hernán Darío Mejía
Claudia Bibiana Peñaranda
References
Creasy RK, Resnik R, Iams JD, editors. Maternal-fetal medicine: principles and practices. Preterm labor and delivery. 5 ed. Philadelphia: Saunders; 2004.
Goldenberg RL. The management of preterm labor. Obstet Gynecol 2002;100:1020-37.
Tucker JM, Goldenberg RL, Davis RO, Cooper RL, Winkler CL, Hauth HC. Etiologies of preterm birth in an indigent population: is prevention a logical expectation? Obstet Gynecol 1991;77:343-7.
Meis PJ, Michielutte R, Peters TJ, Wells HB, Sands RE, Coles EC, et al. Factors associated with preterm birth in Cardiff, Wales. II. Indicated and spontaneous preterm birth. Am J Obstet Gynecol, 1995;173:597-9.
Meis PJ, Goldenberg RL, Mercer BM, Iams JD, Moawad AH, Miodovnik M, et al. The preterm prediction study: risk factors for indicated preterm birth. Maternal-Fetal Medicine Units Network of the National Institute of Child Health and Human Development. Am J Obstet Gynecol 1998;178:562-5.
Goldenberg RL, Iams JD, Mercer BM, Meis PJ, Moawad AH, Copper RL, et al. The preterm prediction study: the value of new vs standard risk factors in predicting early and all spontaneous preterm births. NICHD MFMU Network. Am J Public Health 1998;88:233-8.
Newman RB. The Preterm Prediction Study: comparison of the cer vical score and Bishop score for the prediction of spontaneous preterm birth. J Soc Gynecol Investig 1997;4:152-A.
Iams JD, Goldenberg RL, Meis PJ, Mercer BM, Moawad A, Des A, et al. The length of the cervix and the risk of spontaneous preterm deliver y. National Institute of Child Health and Human Development Maternal Fetal Medicine Unit Network. N Engl J Med 1996;334:567-72.
The American College of Obstetricians and Gynecologists. ACOG practice bulletin. Assessment of risk factors for preterm birth. Clinical management guidelines for obstetrician-gynecologists. Number 31, October 2001. Obstet Gynecol 2001;98:709-16.
Cnattingius S, Granath F, Petersson G, Harlow BL. The influence of gestational age and smoking habits on the risk of subsequent preterm deliveries. N Engl J Med 1999;341:943-8.
Hillier SL, Nugent RP, Eschenbach DA, Krohn MA, Gibbs RS, Martin DH, et al. Association between bacterial vaginosis and preterm delivery of low birth-weight infant. The Vaginal Infections and Prematurity Study Group. N Engl J Med 1995;333:1737-42.
Gomez R, Galasso M, Romero R, Mazor M, Sorokin Y, Goncalves L, et al. Ultrasonographic examination of the uterine cervix is better than cervical digital examination as a predictor of the likelihood of premature delivery in patients with preterm labor and intact membranes. Am J Obstet Gynecol 1994;171:956-64.
Iams JD, Paraskos J, Landon MB, Teteris JN, Johnson FF. Cer vical sonography in preterm labor. Obstet Gynecol 1994;84:40-6.
Timor-Tritsch IE, Boozarjomehri F, Masakowski Y, Monteagudo A, Chao CR. Can a “snapshot” sagital view of the cer vix by transvaginal ultrasonography predict active preterm labor? Am J Obstet Gynecol 1996;174:990-5
Iams JD. Prediction and early detection of preterm labor. Obstet Gynecol 2003;101:402-12.
How to Cite
Downloads
Downloads
Published
Issue
Section
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
