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Paper Information

Journal:   INTERNATIONAL JOURNAL OF REPRODUCTIVE BIOMEDICINE (IRANIAN JOURNAL OF REPRODUCTIVE MEDICINE)   November 2017 , Volume 15 , Number 11; Page(s) 697 To 702.
 
Paper: 

Triage by cervical length sonographic measurements for targeted therapy in threatened preterm labor: A double blind randomized clinical trial

 
 
Author(s):  VAFAEI HOMEIRA*, Rahimirad Neda, Hosseini Seyedeh Marjan, KASRAEIAN MARYAM, ASADI NASRIN, Raeisi Shahraki Hadi, Bazrafshan Khadijeh
 
* Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
 
Abstract: 
Background: Preterm labor and birth are associated with several neonatal complications including respiratory distress syndrome and intraventricular hemorrhage. Differentiating true and false labor pain is a dilemma to obstetricians. Objective: To elucidate the role of cervical length measurement in prediction of birth in pregnant women with threatened preterm labor. Materials and Methods: In this double blind randomized clinical trial, 120 women with gestational age <34 wk who presented painful uterine contractions randomly assigned to undergo measurement of cervical length. Patients were registered in the hospital and a unit number was given. Based on the unit numbers, patients were randomly assigned to two groups using a computerized random digit generator. All participants were managed accordingly (n=65) or to receive tocolysis as planned (n=55). Tocolysis was prescribed when cervical length was <15 mm while those with cervical length ≥ 15 mm were managed expectantly. Delivery within 7 days of the presentation was the primary outcome. Results: This RCT showed in case group, 78. 9% of patient with cervical length <15 mm were delivered within 7 days and only 21. 1% of them maintained their pregnancy. Of those with cervical length ≥ 15 mm, only 15. 2% were delivered within the study period and the rest (84. 8%) maintained their pregnancy (p<0. 001). Conclusion: “ Our results indicate that in women who presented preterm labor symptoms, cervical length measurement will result in decreased unnecessary tocolytic treatment. Women with cervical length ≥ 15mm should not receive tocolysis, however, withholding corticosteroid therapy in these patients needs further evidence.
 
Keyword(s): Cervical length,Preterm labor,Tocolysis,Ultrasonography
 
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