Use of fetal fibronectin and transvaginal ultrasound cervical length to triage women with suspected preterm labor: A randomized trial

2006 ◽  
Vol 195 (6) ◽  
pp. S67 ◽  
Author(s):  
Amen Ness ◽  
John Visintine ◽  
Emily Ricci ◽  
Krystene Boyle ◽  
Vincenzo Berghella
Keyword(s):  
Randomized Trial ◽  
Preterm Labor ◽  
Transvaginal Ultrasound ◽  
Cervical Length ◽  
Fetal Fibronectin

scholarly journals Preterm labor: issues of prognosis, prevention and management (Literature rewiew)

2021 ◽  
Vol 3 ◽  
pp. 57-64
Author(s):  
Ye. Petrenko ◽  
K.P. Strubchevka
Keyword(s):  
Neonatal Mortality ◽  
Preterm Labor ◽  
Transvaginal Ultrasound ◽  
Perinatal Care ◽  
Cervical Length ◽  
Fetal Fibronectin ◽  
Uterine Contractions ◽  
Therapeutic Measures ◽  
Group B ◽  
Amniotic Membranes

Preterm labor is the leading cause of neonatal mortality and the most common cause for antenatal hospitalization. Approximately 15 million babies are born preterm each year worldwide. Of those, one million babies die before the age of 5, which is 18% of all deaths of children at this age. 35% of early and late neonatal mortality (under 28 days of age) is associated with preterm birth.The pathophysiology of preterm labor includes at least four major pathogenetic mechanisms. The studied components of this process are premature activation of the maternal or fetal hypothalamic-pituitary-adrenal system, inflammation or infection, decidual hemorrhage and pathological overdistension of the uterus. The diagnosis of preterm labor is based on the determination of concomitant regular uterine contractions and cervical changes. Vaginal bleeding and/or rupture of the amniotic membranes only increase the likelihood of this diagnosis. To improve the accuracy of diagnosis and assess the potential risk of preterm birth in the presence of symptoms in pregnant women, it is proposed to use such diagnostic tests as transvaginal ultrasound to measure cervical length; detection in vaginal fluids of fetal fibronectin (fFN), phosphorylated protein-1, which binds insulin-like growth factor (IGFBP-1), placental alpha-microglobulin, the ratio of insulin-like growth factorebinding protein 4 (IBP4) and sex hormoneebinding globulin (SHBG) – PreTRM-test.Correct identification of women in the true preterm labor allows performing appropriate actions, which results in better outcomes for the newborn. These are using of corticosteroids to prevent respiratory distress syndrome (RDS) of the newborn; prevention of group B streptococcal infection; magnesium sulfate to protect the baby’s nervous system; transportation to the institution of the third level of perinatal care, which can provide a newborn with appropriate medical care. Preventative and therapeutic measures for women, which have a high risk of preterm labor, include taking progesterone, cervical cerclage and an application of obstetric pessary.

scholarly journals Diagnosis and Management of Short Cervix in Singleton Pregnancies

2011 ◽  
Vol 2 (1) ◽  
pp. 15-18
Author(s):  
Igal Wolman ◽  
Arnon Agmon ◽  
J Ariel
Keyword(s):  
Perinatal Mortality ◽  
Gestational Age ◽  
Preterm Labor ◽  
Transvaginal Ultrasound ◽  
Cervical Length ◽  
Ultrasound Screening ◽  
Cervical Cerclage ◽  
Short Cervix ◽  
Fetal Fibronectin ◽  
Singleton Pregnancies

ABSTRACT Prevention of preterm labor will reduce perinatal mortality. Screening of cervical length by ultrasound should begin at 16 weeks by transvaginal ultrasound. If the cervical length is more than 35 mm, the exam should be repeated every 2 to 3 weeks till 32 weeks. If the cervical length is between 25 and 35 mm the ultrasound screening should be done weekly or biweekly. Fetal fibronectin estimation should provide supplemental information. If the cervical length is less than 25 mm cervical cerclage should be performed if gestational age is less than 22 weeks. Progesterone therapy is preferred if the gestational age is more than 22 completed weeks.

scholarly journals Triage of women with possible preterm labor using transvaginal ultrasound cervical length and fetal fibronectin

2005 ◽  
Vol 193 (6) ◽  
pp. S58
Author(s):  
Amen Ness (F) ◽  
James Airoldi ◽  
Alisa Modena ◽  
Jason Baxter ◽  
Vincenzo Berghella
Keyword(s):  
Preterm Labor ◽  
Transvaginal Ultrasound ◽  
Cervical Length ◽  
Fetal Fibronectin

scholarly journals Transvaginal Ultrasound Assessment of Cervical Length in Threatened Preterm Labor

2020 ◽  
pp. 81-84
Author(s):  
Prasila Ekaputri
Keyword(s):  
Preterm Labor ◽  
Primary Outcome ◽  
Uterine Contraction ◽  
Transvaginal Ultrasound ◽  
Cross Sectional Study ◽  
Cervical Length ◽  
Cross Sectional ◽  
Active Labor ◽  
Ultrasound Assessment ◽  
Threatened Preterm Labor

Objectives: To determine the cut off point of cervical length usingtransvaginal ultrasonography to predict the actual occurrence ofpreterm labor in women with threatened preterm labor. Methods: A cross sectional study with consecutive random samplingmethod. We examined 80 women with singleton pregnancycomplaining of regular, painful uterine contraction and rupturedmembrane at 24-36 weeks of gestation. Women in active labor, definedby the presence of cervical dilatation less than or equal 3 cm, and having complicationwere excluded. When the patient was admitted, a transvaginalscan was performed to measure the cervical length. Parenteralmagnesium sulfate was given as the subsequent management.The primary outcome was delivery within 24 hours of presentation.Results: We found that the optimal cut off values for cervical lengthwas 2.65 cm with sensitivity 94.4 Percent, specificity 65.4Percent, positive predictivevalue 75.4 Percent and negative predictive value 81.8 Percent. In 69cases, the cervical length was more than or 2.65 cm, with 52 patients successfullycontinued their pregnancy until more than 24 hours. In the 11cases with cervical length less than or equal 2.65 cm, delivery within 24 hours occurredin 9 cases (81,8 Percent). Conclusion: The findings of this study suggest that in women withthreatened preterm labor, cervical length more than or equal 2.65 cm may help predictthe actual occurrence of preterm labor. Keywords: cervical length, threatened preterm labor, transvaginalultrasonography

747: Cervical length significantly modifies the risk of preterm delivery in low risk patients with symptomatic preterm labor and a positive fetal fibronectin

2008 ◽  
Vol 199 (6) ◽  
pp. S212
Author(s):  
James Kurtzman ◽  
Guillermo Jimenez-Solis ◽  
Sergio Rosales-Ortiz ◽  
Oscar Martinez-Alvarez ◽  
Anita Das ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Preterm Labor ◽  
Cervical Length ◽  
Low Risk ◽  
Fetal Fibronectin ◽  
Risk Patients

scholarly journals UMA ANÁLISE INTEGRAL DO TRABALHO DE PARTO PREMATURO

2019 ◽  
Vol 6 (1) ◽  
pp. 54-57
Author(s):  
Renata dos Santos Oliveira ◽  
Maria Luiza Silva Brito ◽  
Delcides Bernardes da Costa Neto
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Early Diagnosis ◽  
Preterm Labor ◽  
Transvaginal Ultrasound ◽  
Treatment Options ◽  
Neonatal Morbidity ◽  
Morbidity And Mortality ◽  
Fetal Fibronectin ◽  
Appropriate Treatment

A prematuridade é um dos mais significativos desafios da obstetrícia, constituindo a principal causa de morbimortalidade neonatal. A presença de fatores de risco, tanto maternos quanto fetais, geram maior vigilância durante o decorrer da gestação, entretanto cada gravidez ocorre de forma singular e seus fatores devem ser analisados individualmente, motivo que nos leva ao estudo profundo e integral de cada um deles. O diagnóstico do trabalho de parto prematuro é eminentemente clínico e, muitas vezes, de difícil estabelecimento precoce. Para auxiliar na obtenção de um diagnóstico em estágio inicial, tem-se empregado métodos complementares, como o ultrassom transvaginal e a fibronectina fetal. Existem várias opções de tratamento com suas particularidades para a indicação, porém a escolha deve ser feita prontamente a fim de prolongar a gestação, evitando os desfechos desfavoráveis do parto prematuro. Palavras-chave: trabalho de parto prematuro; diagnóstico precoce; tratamento adequado ABSTRACT Prematurity is one of the most significant challenges of obstetrics, being the main cause of neonatal morbidity and mortality. The presence of risk factors, both maternal and fetal, generate greater vigilance during the course of gestation, however each pregnancy occurs in a singular way and its factors must be analyzed individually, reason that leads us to the deep and integral study of each one of them. The diagnosis of preterm labor is eminently clinical and often difficult to establish early. To assist in obtaining an early diagnosis, complementary methods have been employed, such as transvaginal ultrasound and fetal fibronectin. There are several treatment options with their particularities for the indication, but the choice must be made promptly in order to prolong the gestation, avoiding the unfavorable outcomes of the preterm birth. Keywords: preterm labor; early diagnosis; appropriate treatment.

scholarly journals Threatened Preterm Labor: Which are become Preterm Labor?

2020 ◽  
pp. 216-222
Author(s):  
Cut M. Yeni ◽  
Rismawati Tambunan ◽  
Hasanuddin
Keyword(s):  
Pregnant Women ◽  
Preterm Labor ◽  
Case Control ◽  
Cervical Length ◽  
Wilcoxon Test ◽  
Fetal Fibronectin ◽  
Whitney Test ◽  
Vaginal Ph ◽  
Chi Squared ◽  
Threatened Preterm Labor

Objective: The research was aimed to show about characteristics of subject, fetal fibronectin, vaginal pH, cervical length of women with threatened preterm labor, and which are become preterm labor? Preterm labor is occurs most often in 20 weeks gestation to less than 37 weeks gestation. This condition is concerned about Obstetric problem and associated with significant neonatal morbidity and mortality.Methods: This study used the design of case control where preterm pregnant women who become research subjects divided into two groups with threat and without the threat of pre-term labor. Fetal fibronectin , vaginal pHand cervical length than in both groups were evaluated as a risk factor for preterm labor. Mann-Whitney test , Wilcoxon test and Chi-squared test were used as statistical tests with a confidence level of 95%.Results: A total of 86 preterm pregnant women involved in this study with an average age 30 , 5 ± 6.25 (group threat) 32.16 ± 5.25 (non-threatening). Comparison of fetal fibronectin (p = 0.005), vaginal PH(p <0.001) and length of the cervix (p <0.001) between the two groups showed a significant difference. A total of 8 subjects of the 43 in the group of pregnant women with the threat pretem labor experiencing preterm labor .Conclusion: The size of a short cervical length, an increase in the pH of the vaginal secretions and increased levels of fetal fibronectin  is a clinical indicator for screening during pregnancy to assess the risk of a preterm labor .Keywords: cervical length, fetal fibronectin, pretermlabor , vaginal pH of the secretions. Abstrak Tujuan: Persalinan preterm adalah persalinan yang terjadi padausia kehamilan 20 hingga kurang dari37 minggu. Kondisi inimerupakanpermasalahan yang sangat mengkhawatirkan dalam bidang kebidanan dan dikaitkan dengan morbiditas dan kematian neonatal yang signifikan. Evaluasi dan skrining terhadap berbagai faktor resiko terjadinya ancaman persalinan preterm adalah hal terpenting dalam mencegah berbagai komplikasi yang mungkin timbul.Metode: Penelitian ini menggunakan desain case control dimana wanita hamil preterm yang menjadi subjek penelitian terbagi menjadi dua yakni kelompok dengan ancaman dan tanpa ancaman persalinan preterm. Fetal fibronectin, pH sekret vagina dan panjang serviks dibandingkan diatara kedua kelompok sebagai faktor resiko ancaman persalinan preterm. Mann-Whitney test, Wilcoxon test dan Chi – squared digunakan sebagai uji statistik dengan tingkat kepercayaan 95%.Hasil: Sebanyak 86 wanita hamil preterm terlibat dalam penelitian ini dengan rerata usia 30,5 ± 6,25 (kelompok ancaman) 32,16 ± 5,25 (tanpa ancaman). Perbandingan Fetal fibronectin (p=0,005), pH sekret vagina (p<0,001) dan panjang serviks (p<0,001) antar kedua kelompok menunjukkan adanya perbedaan yang bermakna. Sebanyak 8 subjek dari 43 pada kelompok wanita hamil pretem dengan ancaman persalinan preterm yang mengalami persalinan pretermKesimpulan:Ukuran panjang serviks yang pendek, peningkatan pH sekret vagina dan peningkatan kadar fetal fibronectin merupakan indikator klinis untuk skrining selama kehamilan guna menilai resiko terjadinya persalinan pretermKata kunci: fetal fibronectin, persalinan preterm, Ph vagina, panjang cerviks  

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