Echographic Assessment of the Cervix for the Prediction of Preterm Delivery

Abstract

Objective: to provide echographic assessment of the cervix in pregnant women at term 16-24 weeks for the prediction of preterm delivery using functional tests. Materials and methods. 61 pregnant during the period from 16 to 24 weeks of gestation with the diagnosis “threat of interruption of pregnancy” we prospectively examined. In addition to standard measurement study involved functional tests. The study, 3 (7.5%) patients in the initial examination was revealed cervical incompetence (CIN). Two clinical groups were distinguished from other 58 pregnant women: group I of 26 patients (44.8%) with existence of risk factors of CIN which the cervical stressful test were not performed and group II of 32 (55.2%) patients to whom test with change of position of a body was carried out. In group II allocated two subgroups: IIA - 11(34.4%) pregnant women without risk factors of CIN; IIb - 21 (65.6%) the pregnant woman with risk factors. Results. At the II group after carrying out functional test with change of position of a body in 9 (28.1%) of 32 patients the cervical stressful test was positive, in 23 (71.9%) - negative. In IIA group shortening of length of the cervix and/or an expansion of the internal os was in 3 (27.3%) patients of 11, from IIb group in 6 (28.6%) of 21. When comparing outcomes of pregnancies it is possible to note that in group I the number of premature birth was higher, than in the II group, besides in the I group there was a late spontaneous abortion. It was succeeded to distinguish group of risk of premature birth for further monitoring and correction among pregnant of group IIa pregnant women without risk factors of CIN by means cervical stressful test. Conclusion. Thus, reducing the length of the cervix and / or increasing the diameter of the internal os, changing its shape are important in predicting preterm labor. Conducting cervical stress test allows you to select a risk group for the development of CIN and preterm birth, including among pregnant women without risk factors for CIN, that allows to carry out in due time keeping therapy and to receive more safe ends of pregnancy.