Revista chilena de obstetricia y ginecología
On-line version ISSN 0717-7526
TORRES CH, Pablo et al. LONGITUD DEL CANAL CERVICAL UTERINO COMO FACTOR DE RIESGO DE PARTO PREMATURO EN PACIENTES SINTOMÁTICAS. Rev. chil. obstet. ginecol. [online]. 2008, vol.73, n.5, pp. 330-336. ISSN 0717-7526. http://dx.doi.org/10.4067/S0717-75262008000500009.
Objective: To determine if the shortening of cervical length (CL) in women with threatened preterm labor could predict delivery at or before 35 weeks' gestation and within 7 days of presentation. Method: Sonogra-phic measurement of CL was done in 852 women with singleton pregnancies presenting with painful uterine contractions. Women in labor, with ruptured membranes or those with cervical cerclage were excluded. Re-sults: Median gestational age at presentation was 31.5 (range: 24.0-34.9) weeks and median cervical length was 31.5 (range: 3-61) mm. Delivery within 7 days occurred in 14 (1.6%) and delivery at or before 35 weeks, in 61 (7.2%) cases. Significant (OR; 95%CI) independent predictors of delivery at or before 35 weeks were vaginal bleeding (6.87; 2.83-16.65), cervical length (3.31; Cl 1.92-5.70) and a historyof preterm birth (2.03; 1.06-3.89). ROC curve analysis showed that a cervical length shorter than 19.5 mm (p<0.05) was the best cutoff valué for predicting a delivery at or before 35 weeks' gestation and within 7 days of presentation. Con-clusions: Shortening of cervical length in threatened preterm labor, especially when shorter than 19.5 mm, is associated with a significant risk of preterm labor <35 weeks' gestation and within 7 days of admission. Sonographic measurement of cervical length helps to recognize patients at risk for preterm birth, in order to focus interventions in that group of patients.
Keywords : Preterm labor; ultrasound; uterine cervix; risk factors.