Prediction of labor onset in women who present with symptoms
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Diagnosis of preterm labor is difficult because initial symptoms and signs are often mild and may occur in continuing pregnancies. This study shows that by using a cervical length cut-off of 27.5mm at presentation, investigators have predicted 77.8?% of deliveries within 1 week.

This study by BMC Pregnancy and Childbirth aims to investigate the utility of measuring cervical length, using transvaginal ultrasound, in women presenting to the delivery suite with symptoms of preterm labor.

This was a prospective cohort study. 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 labor ward, after four hours, and in the following morning. The primary outcome of the study was delivery within 1 week. A total of 95 subjects were included.

--A one-millimeter increase in the 1st cervical length increases the scan-to-delivery time by 0.802 days.

--Receiver Operator Characteristic (ROC) curve analysis for prediction of delivery within 1 week showed an Area Under Curve (AUC) of 0.667, an optimal cut-off value of 27.5mm.

--A one-millimeter increase in the 3rd cervical length increases the scan-to-delivery time by 0.770 days.

--ROC curve analysis for prediction of delivery within 1 week showed an AUC of 0.915, an optimal cut-off value of 25.5mm. However, the change in cervical length over a period of 1 day was not significant in predicting delivery within 1 week.

Conclusively, measuring the transvaginal ultrasound cervical length is a reliable diagnostic test for delivery within 1 week.

Source: https://doi.org/10.1186/s12884-021-03828-z
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