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Article Type

Original Study

Abstract

Objective The present study was conducted to evaluate cervical length measurement, placental score, and amniotic fluid volume by ultrasound, and the level of fetal fibronectin (FFN) between 24 and 34 weeks of gestation as predictors of preterm labor. Background Spontaneous preterm birth continues to be the major contributor to perinatal morbidity and mortality. Early detection of preterm labor is difficult because initial symptoms and signs are often mild and may occur in normal pregnancy. The traditional criteria for preterm labor (persistent contractions accompanied by progressive cervical dilatation and effacement) are most accurate. Other means have been thought to detect preterm labor early. These include ultrasound examination of the cervix to measure the cervical length, measurement of amniotic fluid index, and detection of FFN in the cervicovaginal sample. Patients and methods This study was carried out on 80 pregnant women attending the antenatal care clinic of Kafr El-Dwar General Hospital from July 2014 to April 2015. The patients were divided into two groups: group one (50 cases), which included patients who have no history of unexplained preterm labor, and group two (30 cases), which included patients who have a history of unexplained preterm labor. Patients were followed up for the occurrence of preterm labor pain. Full complete history was taken from all cases, and then general examination was done for them. FFN testing and transabdominal and transvaginal ultrasound examination between 24 and 34 weeks of gestation with assessment of cervical length, fetal viability, number, fetal biometry (biparietal diameter, femur length, abdominal circumference), placenta (score, site, and maturity), and amniotic fluid (amount and turbidity) were performed. Results The results of this study revealed that the risk of preterm delivery (PTD) is inversely correlated with cervical length. Routine transvaginal scan of the cervix performed between 24 and 34 weeks helped to identify patients at risk of PTD; women with oligohydramnios are found to be liable to develop preterm labor. Assay of FFN in cervicovaginal secretions has proven to be a valuable test in the prediction of spontaneous PTD. Conclusion The first step in the prevention of preterm labor is early identification of women at risk for preterm birth by the use of ultrasonography to detect cervical length and amniotic fluid volume and by the detection of FFN in cervicovaginal secretion.

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