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| Die prognostische Aussagekraft der sonographischen Zervixlängenmessung bei Schwangeren mit drohender Frühgeburt Osthues, Kathrin Ellen |
| Main title | Die prognostische Aussagekraft der sonographischen Zervixlängenmessung bei Schwangeren mit drohender Frühgeburt |
| Title variations | The value of cervical length for the prediction of preterm delivery in pregnant women presenting with threatened preterm labor or preterm prelabor amniorrhexis |
| Author(s) | Osthues, Kathrin Ellen
Place of birth: Berlin |
| 1. Referee | Priv.- Doz. Dr. med. I. Fuchs |
| Further Referee(s) | Prof. Dr. med. F. Kainer Prof. Dr. med. J. Sehouli |
| Keywords | preterm labor; preterm prelabor amniorrhexis; preterm delivery; cervical length; prediction of delivery; sonographic measurement |
| Classification (DDC) | 610 Medical sciences; Medicine |
| Summary | False positive diagnosis of preterm labor is common. The aim of this study was to investigate the hypothesis that in women with threatened preterm labor, sonographic measurement of cervical length helps distinguish between true and false labor and to determine whether sonographic measurement of cervical length in pregnancies complicated by preterm prelabor amniorrhexis helps distinguish between those women who deliver within 7 days and those who do not. METHODS: Cervical length was measured by transvaginal ultrasound in 252 women with singleton pregnancies presenting with painful uterine contractions and in 48 women with singleton pregnancies presenting with preterm prelabor amniorrhexis at a median age of 31 (range, 24-36) weeks of gestation. Delivery within 7 days of presentation occurred in 23/253 (9,1%) women with preterm labor and 20/48 (41,7%) of those with preterm prelabor amniorrhexis. This was inversely related to cervical length in both groups. Receiver-operating characteristics (ROC) curves established a cervical length of 15 mm as the most relevant cut-off level for the prediction of preterm delivery within 7 days for the first group. The best cut-off for women with preterm prelabor amniorrhexis was a cervical length of 25 mm. Logistic regression analysis demonstrated that significant independent contribution in the prediction of delivery within 7 days was provided by cervical length (odds ratio (OR) = 0.014, 95% CI 0.004-0.064, P < 0.0001), Elevation of the C-reactive protein (OR = 4.74, 95% CI 1.3-16.79, P < 0.016) and the ocurrence of vaginal bleeding (OR = 7.13, 95% CI 1.49-34.11, P < 0.014) in women with preterm labor and cervical length only in women with preterm prelabor amniorrhexis (OR) = 0.1, 95% CI 0.25-0.39, P = 0.001) with no significant independent contribution from ethnic origin, maternal age, body mass index, parity, previous history of preterm delivery, cigarette smoking, or the administration of tocolytics, antibiotics or steroids. CONCLUSION: In women with threatened preterm labor, sonographic measurement of cervical length helps distinguish between true and false labor. In women with preterm prelabor amniorrhexis prediction of delivery within 7 days is provided by cervical length. |
| Documents |
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| FU Department | Department of Medicine - Charité - University Medicine Berlin |
| Year of publication | 2012 |
| Document type | Doctoral thesis |
| Media type/Format | Text |
| Language | German |
| Terms of use/Rights | Nutzungsbedingungen |
| Date of defense | 2012-02-24 |
| Created at | 2012-01-30 : 12:05:05 |
| Last changed | 2012-03-01 : 08:48:55 |
| Static URL | http://www.diss.fu-berlin.de/diss/receive/FUDISS_thesis_000000036038 |
| NBN | urn:nbn:de:kobv:188-fudissthesis000000036038-5 |
| Statistics | |
| E-mail address | Osthues_kathrin@web.de |
