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Reyna Villasmil E, Mejia Montilla J, Reyna Villasmil N, Torres Cepeda D, Rondon Tapia M, Briceño Pérez C. Utilidad del volumen cervical o longitud cervical en la predicción de parto pretérmino inminente en pacientes sintomáticas. REPERTORIO DE MEDICINA Y CIRUGÍA 2022. [DOI: 10.31260/repertmedcir.01217372.1298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introducción: el volumen cervical es un indicador del proceso de remodelación del cuello uterino. Investigaciones previas han señalado que puede superar la precisión pronóstica de la longitud cervical en la predicción del parto pretérmino. Objetivo: establecer la utilidad del volumen cervical comparado con la longitud en la predicción de parto pretérmino inminente en pacientes sintomáticas. Materiales y métodos: estudio prospectivo realizado de junio 2014 a mayo 2020 en pacientes con diagnóstico de amenaza de parto pretérmino. A todas se les realizo la cuantificación del volumen y longitud cervical por ecografía transvaginal en la hora siguiente a la admisión. Fueron clasificados en aquellas con partos antes de 7 días (grupo A) y con más de 7 días (grupo B). Resultados: para el análisis final se incluyeron 326 pacientes, 152 (31,7%) pertenecieron al grupo A y 251 al B. Las primeras presentaron valores menores de volumen cervical y longitud cervical comparadas con las del grupo B (p < 0,0001). El volumen mostró un valor de área de 0,897 comparado con 0,977 de la longitud cervical para la predicción de parto pretérmino inminente (p < 0,0001). Conclusión: el volumen cervical es menos útil que la longitud en la predicción de parto pretérmino inminente en pacientes sintomáticas.
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Wong TTC, Yong X, Tung JSZ, Lee BJY, Chan JMX, Du R, Yeo TW, Yeo GSH. Prediction of labour onset in women who present with symptoms of preterm labour using cervical length. BMC Pregnancy Childbirth 2021; 21:359. [PMID: 33952198 PMCID: PMC8097783 DOI: 10.1186/s12884-021-03828-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/23/2021] [Indexed: 11/26/2022] Open
Abstract
Background Diagnosis of preterm labour is difficult because initial symptoms and signs are often mild and may occur in continuing pregnancies. This study aims to investigate the utility of measuring cervical length, using transvaginal ultrasound, in women presenting to the delivery suite with symptoms of preterm labour. Methods This was a prospective cohort study performed in KK Women’s and Children’s Hospital, Singapore from September 2017 to July 2018. Women with singleton pregnancies, presenting with symptoms of contraction pain, between 24+ 0 to 36+ 6 weeks gestation, were included. Transvaginal ultrasound cervical length measurements were done at presentation to the labour ward, after four hours and in the following morning. The primary outcome of the study was delivery within 1 week. All statistical analyses were conducted with Microsoft Excel and Statistical Package for the Social Sciences. Results A total of 95 subjects were included. A one-millimeter increase in the 1st cervical length increases scan-to-delivery time by 0.802 days (p-value 0.003, CI 0.280–1.323). Receiver Operator Characteristic (ROC) curve analysis for prediction of delivery within 1 week showed an Area Under Curve (AUC) of 0.667, optimal cut-off value of 27.5mm (sensitivity 77.8 %, specificity 61.6 %). A one-millimetre increase in the 3rd cervical length increases scan-to-delivery time by 0.770 days (p-value 0.023, CI 0.108–1.432). ROC curve analysis for prediction of delivery within 1 week showed an AUC of 0.915, optimal cut-off value of 25.5mm (sensitivity 100 %, specificity 73.6 %). However, the change in cervical length over a period of 1 day was not significant in predicting delivery within 1 week. Conclusions Our results indicate that by using a cervical length cut off of 27.5mm at presentation, we would have predicted 77.8 % of deliveries within 1 week. If we were to repeat the cervical length scan the next day, with the same cut-off of 27.5mm, we would have predicted 100 % of deliveries within 1 week. In our study, measuring the transvaginal ultrasound cervical length is a reliable diagnostic test for delivery within 1 week. However, the results are limited by the small sample size. Further studies should be conducted with a larger sample size.
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Affiliation(s)
- Tiffany Tuck Chin Wong
- Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore, Singapore.
| | - Xiaoqi Yong
- Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore, Singapore
| | - Janice Su Zhen Tung
- Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore, Singapore
| | - Beatrice Jia Ying Lee
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Joanne Mei Xin Chan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Ruochen Du
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Tai Wai Yeo
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - George Seow Heong Yeo
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
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Measurement of the uterocervical angle for the prediction of preterm birth in symptomatic women. Arch Gynecol Obstet 2021; 304:663-669. [PMID: 33674963 PMCID: PMC8325658 DOI: 10.1007/s00404-021-06002-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/10/2021] [Indexed: 11/04/2022]
Abstract
Purpose To examine if the uterocervical angle (UCA) can be used to predict preterm delivery in women with painful and regular uterine contractions and a cervical length of 25 mm or less. Methods Retrospective study at the perinatal unit of the University Hospital of Tuebingen, Germany. Women with singleton gestation and preterm contractions between 24 + 0 and 33 + 6 weeks’ gestation were included. For the UCA measurement, a line is placed from the internal os to the external os irrespective of whether the cervix is straight or curved. A second line is drawn to delineate the lower uterine segment. The angle between the two lines is the UCA measurement. The measurements were taken on stored images from our database. Results The study consisted of 213 singleton pregnancies. At the time of UCA measurement, median maternal and gestational age was 31.4 years and 29.7 weeks’ gestation. Median gestational age at delivery was 35.3 weeks and the corresponding birth weight 2480 g, respectively. The UCA measurement in women who delivered within 2 days, between 3–7 days and after 7 days was not helpful to distinguish between these three groups [median UCA measurements: 108.5°, 108.0° and 107.3° (Kruskal–Wallis test p = 0.576)]. Uni- and multivariate logistic multiple regression analysis demonstrated that the delivery within 2 days was only dependent on the gestational age and the cervical length at the time of presentation. Conclusion The measurement of UCA is not useful in predicting preterm birth in the subsequent 7 days after an episode of preterm contractions.
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Chiossi G, Facchinetti F, Vergani P, Di Tommaso M, Marozio L, Acaia B, Pignatti L, Locatelli A, Spitaleri M, Benedetto C, Zaina B, D'Amico R. Serial cervical-length measurements after first episode of threatened preterm labor improve prediction of spontaneous delivery prior to 37 weeks' gestation. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2021; 57:298-304. [PMID: 32851714 DOI: 10.1002/uog.22188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/10/2020] [Accepted: 08/18/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To assess whether repeat cervical-length (CL) measurement in women discharged from hospital after their first episode of threatened preterm labor can predict their risk of spontaneous preterm birth. METHODS This was a secondary analysis of a randomized controlled trial of maintenance tocolysis, in which CL was measured on transvaginal ultrasound at the time of hospital discharge and after 2, 4, 8 and 12 weeks, in women who remained undelivered after their first episode of threatened preterm labor. After univariate analysis, multivariate logistic regression analysis was used to assess whether CL < 10 mm at the time of hospital discharge or at any follow-up evaluation could predict spontaneous delivery prior to 37 weeks of gestation. RESULTS Of 226 women discharged after a diagnosis of threatened preterm labor, 57 (25.2%) delivered spontaneously prior to 37 weeks' gestation. The risk of spontaneous preterm birth was higher among women with CL < 10 mm at hospital discharge compared to those with CL ≥ 10 mm (adjusted odds ratio (aOR), 3.3; 95% CI, 1.2-9.2). Moreover, spontaneous preterm delivery was more common when CL < 10 mm was detected up to 2 weeks (aOR, 2.9; 95% CI, 1.1-7.3) or up to 4 weeks (aOR, 7.3; 95% CI, 2.3-22.8) post discharge, as compared with when CL was persistently ≥ 10 mm. The association was not significant when considering CL measurements at 8 weeks, and there was insufficient information to assess the effect of measurements obtained at 12 weeks. CONCLUSIONS Women who remain undelivered after their first episode of threatened preterm labor continue to be at high risk of spontaneous preterm birth if their CL is below 10 mm at the time of hospital discharge or at any follow-up visit up to 4 weeks later. CL measurement could be included in the antenatal care of these women in order to stratify their risk of preterm birth, rationalize resource utilization and help clinicians improve pregnancy outcome. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- G Chiossi
- Division of Obstetrics, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy
| | - F Facchinetti
- Division of Obstetrics, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy
| | - P Vergani
- Department of Medicine and Surgery, Obstetrics and Gynecology Branch, University of Milano-Bicocca Health Science, Milan, Italy
| | - M Di Tommaso
- Health Science Department, Obstetrics and Gynecology Branch, University of Florence, Florence, Italy
| | - L Marozio
- Department of Surgical Sciences, Gynecology and Obstetrics 1, University of Turin, Turin, Italy
| | - B Acaia
- Department of Medicine and Surgery, Obstetrics and Gynecology Branch, University of Milano-Bicocca Health Science, Milan, Italy
| | - L Pignatti
- Division of Obstetrics, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy
| | - A Locatelli
- Department of Medicine and Surgery, Obstetrics and Gynecology Branch, University of Milano-Bicocca Health Science, Milan, Italy
| | - M Spitaleri
- Health Science Department, Obstetrics and Gynecology Branch, University of Florence, Florence, Italy
| | - C Benedetto
- Department of Surgical Sciences, Gynecology and Obstetrics 1, University of Turin, Turin, Italy
| | - B Zaina
- Department of Medicine and Surgery, Obstetrics and Gynecology Branch, University of Milano-Bicocca Health Science, Milan, Italy
| | - R D'Amico
- Statistics Unit, Department of Diagnostic and Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Modena, Italy
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Prodan N, Wagner P, Sonek J, Abele H, Hoopmann M, Kagan KO. Single and repeat cervical-length measurement in twin gestation with threatened preterm labor. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2020; 55:496-501. [PMID: 31066097 DOI: 10.1002/uog.20306] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 04/25/2019] [Accepted: 04/25/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To examine the effectiveness of single and repeat sonographic cervical-length (CL) measurement in predicting preterm delivery in symptomatic women with a twin pregnancy. METHODS This was a retrospective study of women with a twin gestation who presented with painful and regular uterine contractions at 24 + 0 to 33 + 6 weeks' gestation at the perinatal unit of the University Hospital of Tübingen, Tübingen, Germany between 2012 and 2018. CL was measured on transvaginal ultrasound at the time of admission and a few days later after cessation of contractions. Treatment included administration of tocolytics (usually oral nifedipine), for no more than 48 h, and administration of steroids if CL was ≤ 25 mm. Patients were clustered into five groups according to the CL measurement obtained at first assessment: < 10.0 mm; between 10.0 and 14.9 mm; between 15.0 and 19.9 mm; between 20.0 and 24.9 mm; and ≥ 25.0 mm. For each group, we calculated the test performance of CL measurement for prediction of preterm delivery within the subsequent 7 days and before 34 weeks' gestation. Regression analysis was used to evaluate the test performance of the second CL measurement for predicting preterm delivery within 7 days after the second assessment. RESULTS The study population consisted of 257 twin pregnancies, of which 80.2% were dichorionic diamniotic. Median maternal and gestational ages at the time of admission were 32.0 years and 29.9 weeks' gestation, respectively. Preterm birth within 7 days of admission occurred in 23 (8.9%) pregnancies, and 82 (31.9%) patients delivered prior to 34 weeks' gestation. Median CL for the entire study population was 17.0 mm. Delivery within 7 days after the first assessment occurred in 29.0%, 10.6%, 4.2%, 6.3% and 0% of women with CL < 10.0 mm, 10.0-14.9 mm, 15.0-19.9 mm, 20.0-24.9 mm and ≥ 25.0 mm, respectively. There was a weak, but significant, association between the CL measurement at the time of admission and the time interval between admission and delivery (interval = 27.9 + 0.58 × CL; P = 0.003, r = 0.184). CL was measured again after a median time interval of 3 (interquartile range (IQR), 2-5) days in 248 cases. Median second CL measurement was 17.0 (IQR, 11.5-22.0) mm. Delivery occurred within the subsequent 7 days after the second measurement in 25/248 (10.1%) cases. Binary regression analysis indicated that the first (odds ratio (OR), 0.895; P = 0.003) and second (OR, 0.908; P = 0.002) CL measurements, but not the difference between the two measurements (OR, 0.961; P = 0.361), were associated significantly with delivery within 7 days after the second measurement. Receiver-operating-characteristics (ROC)-curve analysis for the prediction of delivery within 7 days after the second assessment did not show a significant difference between the predictive performance of the first (area under ROC curve (AUC), 0.676 (95% CI, 0.559-0.793)) and the second (AUC, 0.661 (95% CI, 0.531-0.790)) measurement. CONCLUSION Sonographic measurement of CL can be helpful in predicting preterm delivery within 7 days of presentation in symptomatic women with a twin gestation; however, the test performance is relatively weak. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- N Prodan
- Department of Obstetrics and Gynaecology, University of Tübingen, Tübingen, Germany
| | - P Wagner
- Department of Obstetrics and Gynaecology, University of Tübingen, Tübingen, Germany
| | - J Sonek
- Fetal Medicine Foundation USA, Dayton, OH, USA
- Division of Maternal Fetal Medicine, Wright State University, Dayton, OH, USA
| | - H Abele
- Department of Obstetrics and Gynaecology, University of Tübingen, Tübingen, Germany
| | - M Hoopmann
- Department of Obstetrics and Gynaecology, University of Tübingen, Tübingen, Germany
| | - K O Kagan
- Department of Obstetrics and Gynaecology, University of Tübingen, Tübingen, Germany
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Li Q, Li C, Jin H. Efficacy of allylestrenol combined with ritodrine on threatened premature labor and its influence on inflammatory factors in peripheral blood. Exp Ther Med 2019; 19:907-912. [PMID: 32010251 PMCID: PMC6966111 DOI: 10.3892/etm.2019.8273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 11/11/2019] [Indexed: 12/01/2022] Open
Abstract
Efficacy of allylestrenol combined with ritodrine on threatened premature labor (TPTL) and its influence on inflammatory factors in peripheral blood were investigated. A total of 206 cases of TPTL patients from 2014 to 2016 were collected in Zhongshan Hospital Affiliated to Fudan University, and 106 cases were treated with allylestrenol combined with ritodrine as a research group and 100 cases were treated with allylestrenol combined with magnesium sulfate as a control group. General information of patients was collected, and changes in the expression levels of IL-17, IL-10 and IL-6 were detected by enzyme-linked immunosorbent assay. Prolonged pregnancy time, success rate of fetal protection and average delivery time of patients were recorded. The adverse pregnancy conditions were compared, including the Apgar score of newborns, birth weight and adverse conditions, and postpartum hemorrhage volume and postpartum hospital stays in the two groups were recorded. Prolonged pregnancy time, success rate of fetal protection and average delivery time in the research group were significantly higher than those in the control group (P<0.05). After treatment, the levels of IL-17, IL-10 and IL-6 in serum of the two groups were significantly lower than those before treatment (P<0.05), and were significantly lower in the research group than in the control group (P<0.05). The average neonatal weight and Apgar score in the research group were significantly better than those in the control group (P<0.05). Postpartum hemorrhage, postpartum hospital stays and incidence rate of toxic side effects, neonatal death, malformation and asphyxia in the research group were significantly lower than those in the control group (P<0.05). Allylestrenol combined with ritodrine can significantly reduce the expression levels of IL-17, IL-10 and IL-6 in TPTL, reduce adverse pregnancy conditions, prolong gestational weeks, and has higher safety and better application value.
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Affiliation(s)
- Qing Li
- Department of Obstetrics, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai 201700, P.R. China
| | - Chunhua Li
- Department of Obstetrics, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai 201700, P.R. China
| | - Hongmei Jin
- Department of Obstetrics, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai 201700, P.R. China
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Can myometrial thickness/cervical length ratio predict preterm delivery in singleton pregnancies with threatened preterm labor? A prospective study. Arch Gynecol Obstet 2019; 299:1275-1282. [DOI: 10.1007/s00404-019-05109-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 03/04/2019] [Indexed: 10/27/2022]
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Maia MC, Nomura R, Mendonça F, Rios L, Moron A. Is cervical length evaluated by transvaginal ultrasonography helpful in detecting true preterm labor? J Matern Fetal Neonatal Med 2019; 33:2902-2908. [PMID: 30668186 DOI: 10.1080/14767058.2018.1564026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: To investigate whether sonographic cervical markers can identify women in true preterm labor and predict delivery within 7 d and before 34 or 37 gestational weeks.Methods: This was a prospective observational study of women with singleton pregnancies and intact membranes given a diagnosis of preterm labor between 25 and 34 weeks and 6 d of gestation and who underwent transvaginal evaluation of the following characteristics: cervical length (CL), CL zeta score, absence of endocervical glandular echo, presence of cervical funneling, and presence of amniotic fluid sludge. The outcomes of interest were spontaneous delivery within 7 d of preterm labor and spontaneous delivery before 34 or 37 gestational weeks.Results: The inclusion criteria were met by 126 women, 31 (25%) of whom were excluded and 95 were analyzed. The median gestational age at admission was 31.9 weeks. The median CL at preterm labor was 22.3 mm (range: 0-42.8 mm). The delivery occurred within 7 d of presentation in 13 (13.7%) cases. Delivery before 34 weeks occurred in 16 (16.8%) cases and before 37 weeks in 40 (42.1%) cases. Logistic regression analysis showed CL in millimeters was an independent predictor of delivery within 7 d (OR 0.918, 95% CI 0.862-0.978, p = .008). For birth before 34 weeks, the predictor was gestational age at admission (OR 0.683, 95% CI 0.539-0.866, p = .002) and before 37 weeks, the presence of cervical funneling (OR 3.778, 95% CI 1.460-9.773, p = .006). The CL ≤ 15 mm had sensitivity and specificity values of 77 and 77%, respectively, and good accuracy (88%) for prediction of delivery within 7 d.Conclusion: The evaluation of the cervix by transvaginal ultrasound in women in preterm labor predicted delivery within 7 d and helped distinguish between true and false labor. The analysis of CL zeta score was not an independent factor to predict delivery in 7 d.
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Affiliation(s)
- Maria Carolina Maia
- Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Roseli Nomura
- Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Fernanda Mendonça
- Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Livia Rios
- Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Antonio Moron
- Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
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Wagner P, Sonek J, Abele H, Sarah L, Hoopmann M, Brucker S, Wu Q, Kagan KO. Effectiveness of the contemporary treatment of preterm labor: a comparison with a historical cohort. Arch Gynecol Obstet 2017; 296:27-34. [PMID: 28484835 DOI: 10.1007/s00404-017-4389-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 04/26/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare the effectiveness of contemporary treatment of preterm labor to a historical cohort. STUDY DESIGN Retrospective matched case-control study to compare the outcomes of patients that were treated for preterm labor at the University Hospital of Tuebingen, Germany in 2014/2015 (current treatment cohort) and 2006/2007 (historical cohort). The study included women with singleton gestations who were admitted with the diagnosis of preterm labor between 24 + 0 and 34 + 0 weeks' gestation and a cervical length of ≤15 mm. Women in the historical cohort were hospitalized until either 34 weeks' gestation or until complete cessation of uterine contractions. They were treated with intravenous beta-mimetics continuously, received antibiotics based on the vaginal culture and corticosteroids regardless of cervical length measurement. Bed rest was always recommended. The current treatment cohort was tocolyzed with an oral calcium channel blocker for approximately 3 days followed by vaginal progesterone until 34 weeks' gestation. Corticosteroids were given only if the cervical length is ≤15 mm. Bed rest was not recommended. RESULTS The study population consisted of 110 pregnancies, 55 in the historical cohort and 55 in the current treatment cohort. At the time of admission, mean gestational age in both groups was 29.3 and 29.7 weeks. In the historical and current treatment cohort the length of the hospitalization was 24.0 and 5.5 days and tocolysis was given for 19.5 and 3.4 days, respectively. In the historical cohort, mean gestational age at delivery was 35.6 weeks. In 63.6% cases delivery occurred prior to 37 weeks. In the current treatment group mean gestational age at the delivery was 37.0 weeks and 36.4% were delivered prior to 37 weeks. CONCLUSION Short-term hospitalization and tocolysis followed by vaginal progesterone for maintenance tocolysis is more effective than a protocol which includes long-term hospital stay, beta-mimetics, antibiotics, and bed rest.
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Affiliation(s)
- Philipp Wagner
- Department of Obstetrics and Gynaecology, University of Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany
| | - Jiri Sonek
- Fetal Medicine Foundation USA, Dayton, OH, USA.,Division of Maternal Fetal Medicine, Wright State University, Dayton, OH, USA
| | - Harald Abele
- Department of Obstetrics and Gynaecology, University of Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany
| | - Loefler Sarah
- Department of Obstetrics and Gynaecology, University of Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany
| | - Markus Hoopmann
- Department of Obstetrics and Gynaecology, University of Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany
| | - Sara Brucker
- Department of Obstetrics and Gynaecology, University of Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany
| | - Qinging Wu
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Karl Oliver Kagan
- Department of Obstetrics and Gynaecology, University of Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany.
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