조기진통 임산부에서의 경질초음파를 이용한 조기분만의 예측

Abstract

Objective: The purpose of this study was to evaluate the diagnostic accuracy of transvaginal ultrasonography in prediction of preterm birth in pathents with preterm labor and intac6t membranes. Materials and Methods: Twenty-five women who had received antenatal care and developed preterm labor with intact membranes were enrolled in this study. Transvaginal ultrasonography was performed to measure the cervical length, and the presence of funneling of internal cervical os was also evaluated. Pregnancy outcome variables were the occurrence of preterm delivery before 38 weeks gestation and the admission-to-delivery interval. Results: Gestational age on admission was 28.6+-4.8 weeks ranging 20-35 weeks in the patients. The admission-to-delivery interval and gestational age at delivery were 44.4+-34.2 days and 35.0+-5.5 weeks, respectively. The prevalence of preterm delivery was 44%(11/25). No cases with funneling was found in this study. With ROC(receiver operating characteristic) curve analysis of the relationship between cervical length and the occurrence of preterm birth, cutoff value 2.5 cm was selected, with which the diagnostic accuracy were sensitivity of 63.3%, specificity of 78.6%, and positive and negitive predictive value of 70.0% and 73.3%, respectively. The admission-to-delivery interval among the patients with cervical length 2.5cm or less was 25.5+-23.8 days, which was significantly shorter than that of the patients with cervical length more than 2.5 cm(57.1+-34.9 dyas, p=0.020). And the incidence of preterm birth of 70.0% among the patients with the cervical length 2.5cm or less was significantly higher than among those with cervical length more than 2.5cm (26.7%, p=0.033). Conclusion: Transvaginal ultrasonographic measurement of cervical length would be a good prognostic parameter in predicting the occurrence of preterm birth in pathents with preterm labor and intact membranes.