Modern possibilities of preterm birth prediction
Keywords:pregnancy, cervical condition, fetal fibronectin, premature deliveries, transvaginal sonography
Purpose of the study is to improve the method of preterm deliveries onset predicting in pregnant women at 24–34 weeks.
Materials and methods. 49 pregnant women with gestational age 24–34 weeks and with diagnosis of “threatening premature deliveries" were comprehensively examined using transvaginal ultrasound. Pregnant women with a shortened cervix ≤25 mm were given a qualitative determination of fetal fibronectin. The average age of pregnant women ranged from 26–34 years and averaged out 31.2 ± 0,6 years.
Study results. Clinically significant structural changes in the cervix were only in 21 (42.9%) pregnant women. The average value of the cervix length varied between 16–24 mm and averaged 18.2 ± 0.4 mm. Positive test on fetal fibronectin in vaginal secretions was in 7 (33.3%) of 21 pregnant women with clinically significant structural changes in the cervix. During 10 days premature birth occurred in 3 (42.9%) of 7 pregnant women with clinically significant cervix shortening and a positive test for fetal fibronectin in the gestation period of 32 weeks. Hospitalization in an obstetric hospital was found to be unjustified in 28 (57.1%) cases.
Conclusions. Combination of a comprehensive assessment of the cervix state and vaginal fetal fibronectin evaluation in pregnant women with risk of preterm deliveries at the outpatient stage allows to predict the manifestation of preterm birth in critical terms also determine the volume and direction of therapy in obstetric department. Combination of this methods help to prevent unwarranted hospitalization of a pregnant woman in an obstetric hospital and as a result it limits the conduct of glucocorticoid therapy and prevent a prolong stay of a pregnant woman in a hospital and the associated contamination with nosocomial bacteria strains.
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