scholarly journals Preterm Labour

2021 ◽  
Author(s):  
Maged Shendy ◽  
Hend Hendawy ◽  
Amr Salem ◽  
Ibrahim Alatwi ◽  
Abdurahman Alatawi
Keyword(s):  
Preterm Birth ◽  
Preterm Labour ◽  
Transvaginal Ultrasound ◽  
Neonatal Morbidity ◽  
Cervical Length ◽  
Fetal Blood ◽  
Fetal Fibronectin ◽  
High Risk Women ◽  
Fetal Blood Sampling ◽  
Fetal Scalp

Preterm delivery is defined as delivery before 37 weeks completed gestation. It represents a major cause of neonatal morbidity and mortality and accounts for 5–10% of all deliveries. Cervical length assessment between 16–24 weeks and positive fetal fibronectin beyond 21 weeks gestation are proved to useful tools in prediction of preterm labour. Treating asymptomatic bacteruia and bacterial vaginosis in high-risk women reduces the incidence of preterm labour. Cervical cerclage is recommended to reduce the incidence of preterm birth in women with 2nd trimester losses and those with cervical length of 25 mm or less on transvaginal ultrasound between 16–24 weks gestation. Atosiban and nifidipine are currently the agents of choice in tocolysis. Antenal steriods in womens with threating preterm labour reduces the perinatal morbidties. Magnisum sulphate role is established for neuroprotection especially in extreme gestations between 24–30 weeks. Vaginal delivery is mode of choice for delivery with consideration to avoid fetal blood sampling, fetal scalp electrodes and ventouse prior to 34 weeks gestations. Caesarean section is considered for obstetric reasons that guide labour management at term.

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.

Fetal Fibronectin, Endotoxin, Bacterial Vaginosis and Cervical Length as Predictors of Preterm Birth and Neonatal Morbidity in Twin Pregnancies

1998 ◽  
Vol 53 (7) ◽  
pp. 402-403
Author(s):  
U.-B. Wennerholm ◽  
B. Holm ◽  
I. Mattsby-Baltzer ◽  
T. Nielsen ◽  
J. Platz-Christensen ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Bacterial Vaginosis ◽  
Neonatal Morbidity ◽  
Cervical Length ◽  
Fetal Fibronectin ◽  
Twin Pregnancies

Influence of transvaginal ultrasound examination on quantitative vaginal fibronectin measurements: a prospective evaluation study

2017 ◽  
Vol 45 (1) ◽  
Author(s):  
Michaela Golic ◽  
Jan-Peter Siedentopf ◽  
Franziska Pauly ◽  
Larry Hinkson ◽  
Wolfgang Henrich ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Transvaginal Ultrasound ◽  
Evaluation Study ◽  
Cervical Length ◽  
Prospective Evaluation ◽  
Fetal Fibronectin ◽  
A Value ◽  
Measurement Results ◽  
Perinatal Center ◽  
Random Fluctuations

AbstractObjective:The most important parameter in prediction of preterm birth is the cervical length measured by transvaginal ultrasound. In cases with mid-range cervical length (10–30 mm), prediction of preterm birth is difficult. In these cases, testing for cervicovaginal fluid fetal fibronectin (fFN) can improve prediction. However, it is unclear whether transvaginal ultrasound itself influences the fFN result. The purpose of this study was to evaluate this issue independent of gestational age and cervical length.Methods:A prospective evaluation study with 96 cases of pregnant women at 20–41 weeks of gestation was conducted in a tertiary perinatal center. A comparison of cervicovaginal fFN samples before and immediately after transvaginal ultrasound was performed. Fetal fibronectin was measured using the Hologic Rapid fFN 10Q system. It was analyzed quantitatively and qualitatively with ≥50 ng/mL as threshold for “positive”. Changes in fFN values following transvaginal ultrasound were measured.Results:Ninety-six percent (69/72) of women with a fFN concentration of <26 ng/mL before ultrasound had a corresponding fFN value <26 ng/mL after ultrasound. Ninety-three percent (13/14) of women with a fFN concentration of ≥100 ng/mL before ultrasound had a corresponding fFN value ≥100 ng/mL after ultrasound. In 80% (4/5) of women with a positive fFN sample but with a value <100 ng/mL, it turned negative (<50 ng/mL) after ultrasound. For fFN concentrations ≥100 ng/mL, there are high random fluctuations in the measurement results.Conclusions:Fetal fibronectin values of <26 ng/mL (for “negative”) and ≥100 ng/mL (for “positive”) from samples taken after ultrasound provide the same qualitative information as when sampled before ultrasound. For the correct interpretation however, quantitative analysis is necessary.

scholarly journals Transvaginal ultrasonographic assessment of cervical length in prediction of preterm labour in high risk asymptomatic women

2018 ◽  
Vol 7 (12) ◽  
pp. 4981
Author(s):  
Seeniamal Pushparaj ◽  
Prasanna Nagaraj
Keyword(s):  
Preterm Birth ◽  
High Risk ◽  
Preterm Labour ◽  
Cost Effective ◽  
Cervical Length ◽  
Length Measurement ◽  
Spontaneous Preterm Birth ◽  
High Risk Women ◽  
Asymptomatic Women ◽  
Cervical Length Measurement

Background: Preterm birth is an important cause of perinatal morbidity and mortality and has long term health implications. Aim of this study was to predict preterm labour by Transvaginal ultrasonographic cervical length measurement in high risk asymptomatic women which may help in decision making in managing these women.Methods: This study was conducted in Department of Obstetrics and Gynecology, Mahathma Gandhi Memorial Government Hospital, Trichy from August 2016 to September 2017 in 130 antenatal women with high risk factors such as prior spontaneous preterm birth, miscarriage. Transvaginal cervical length was measured and Gestational age at which delivery occurred was correlated and results were analyzed.Results: In present study, sensitivity of transvaginal cervical length measurement (cut off cervical length <25 mm) was 70.9% and specificity was 63% in prediction of preterm labour in high risk asymptomatic women. Positive and negative predictive value of cervical length in predicting preterm labour were 63.7 %and 70% respectively.Conclusions: Transvaginal cervical length measurement can be combined with anomaly scan in high risk women to predict preterm labor and is objective, reproducible and cost effective.

Prediction of preterm birth: the role cervical assessment by ultrasound and cervico-vaginal biomarkers

2020 ◽  
Author(s):  
Giuseppe Rizzo ◽  
Ilenia Mappa Mappa ◽  
Victoria Bitsadze ◽  
Jamilya Khizroeva ◽  
Alexander Makatsariya
Keyword(s):  
Preterm Birth ◽  
Neonatal Morbidity ◽  
Cervical Length ◽  
Fetal Fibronectin ◽  
Neonatal Deaths ◽  
A Value ◽  
Increased Risk ◽  
Asymptomatic Women

Preterm delivery (PTB) is one of the most common and serious complications of pregnancy. PTB accounts for approximately 70% of neonatal deaths and is a major cause of neonatal morbidity including respiratory distress syndrome, necrotising enterocolitis and long-term neurological disabilities. Prevention of PTB and its complications include identification among symptomatic women those at high risk of immediate delivery requiring prenatal corticosteroids administration. Transvaginal ultrasonographic evaluation of the cervical length (CL) is predictive of PTB and a value 15 mm identifies among symptomatic women approximately 70% of women who will deliver within one week. In the range of CL within 15 and 30 mm biomarkers n cervical-vaginal fluids (fetal fibronectin, phosphorylated insulin-like growth factor protein-1, placental alpha-microglobulin-, cytokines) and other ultrasonographic cervical variables (posterior cervical angle, elastography) improve the identification of women at risk, In asymptomatic women CL can be applied as screening and has been proposed as a universal screening during the second trimester in singleton gestations. The finding of a CL25mm is associated with an increased risk of subsequent PTB with a sensitivity between 30 and 60% that is improved with the combination of biomarkers. Asymptomatic women with a CL 25mm should be offered vaginal progesterone treatment for the prevention of preterm birth and neonatal morbidity. The role of cerclage and pessary is still controversial. In this review we discuss the evidence-based role of ultrasonographic cervical assessment and cervicovaginal biomarkers in the prediction of PTB in symptomatic and asymptomatic women

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