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Prediction of preterm delivery in the second trimester
Mário Henrique Burlacchini de Carvalho1, Roberto Eduardo Bittar, Maria de Lourdes Brizot
1Department of Obstetrics, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil. marioburlacchini@uol.com.br
Obstetrics and Gynecology
|March 2, 2005
Summary
Transvaginal ultrasound cervical assessment, combined with a history of preterm birth, can help predict delivery before 34 weeks. This combined approach improves the accuracy of identifying pregnancies at high risk for early delivery.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Diagnostic Ultrasound
Background:
- Preterm delivery before 34 weeks poses significant risks to neonates.
- Accurate prediction of preterm delivery is crucial for timely intervention and improved outcomes.
- Cervical length assessment via transvaginal ultrasound is a known predictor of preterm birth.
Purpose of the Study:
- To estimate the probability of spontaneous delivery at or before 34 weeks of gestation.
- To evaluate the utility of transvaginal cervical assessment in predicting preterm delivery.
- To determine the combined predictive value of cervical assessment and obstetric history.
Main Methods:
- 1,958 singleton pregnancies were assessed between 21-24 weeks gestation.
- Transvaginal ultrasound measured cervical length and noted funneling.
- Data were analyzed with previous obstetric history (preterm delivery, miscarriage, curettage) using multivariable regression.
Main Results:
- The incidence of delivery at or before 34 weeks was 3.4%.
- Shorter cervical length and presence of funneling were significantly associated with earlier delivery (P < .001).
- Previous preterm delivery history, cervical length, and funneling were independent predictors of preterm delivery.
Conclusions:
- Transvaginal ultrasound cervical assessment is a valuable tool for predicting preterm delivery.
- Integrating cervical assessment with obstetric history enhances prediction accuracy.
- This combined approach aids in identifying high-risk pregnancies for preterm birth.