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Volume 15, Issue 11 (11-2017)
IJRM 2017, 15(11): 697-702 |
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Vafaei H, Rahimirad N, Hosseini S M, Kasraeian M, Asadi N, Raeisi Shahraki H et al . Triage by cervical length sonographic measurements for targeted therapy in threatened preterm labor: A double blind randomized clinical trial. IJRM 2017; 15 (11) :697-702
URL: http://ijrm.ir/article-1-901-en.html
URL: http://ijrm.ir/article-1-901-en.html
Homeira Vafaei * 
1, Neda Rahimirad2 , Seyedeh Marjan Hosseini3 , Maryam Kasraeian4 , Nasrin Asadi2 , Hadi Raeisi Shahraki5 , Khadijeh Bazrafshan6
1, Neda Rahimirad2 , Seyedeh Marjan Hosseini3 , Maryam Kasraeian4 , Nasrin Asadi2 , Hadi Raeisi Shahraki5 , Khadijeh Bazrafshan6
1- Maternal-Fetal Medicine Research Center, Perinatology Ward, Shiraz University of Medical Sciences, Shiraz, Iran , Vafaeih@gmail.com
2- Maternal-Fetal Medicine Research Center, Perinatology Ward, Shiraz University of Medical Sciences, Shiraz, Iran
3- Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran
4- Maternal-Fetal Medicine Research Center, Perinatology Ward, Shiraz University of Medical Sciences, Shiraz, Iran.
5- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
6- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
2- Maternal-Fetal Medicine Research Center, Perinatology Ward, Shiraz University of Medical Sciences, Shiraz, Iran
3- Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran
4- Maternal-Fetal Medicine Research Center, Perinatology Ward, Shiraz University of Medical Sciences, Shiraz, Iran.
5- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
6- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Abstract: (4638 Views)
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.
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.
Type of Study: Original Article |
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