A PROSPECTIVE CLINICAL-STUDY FOR THE PREDICTION OF PRETERM DELIVERY IN A LOW-RISK POPULATION

Objective: To determine whether preterm delivery can be predicted by u sual clinical examinations. Methods: For 298 pregnant women without th e risks of preterm delivery, four clinical examinations, namely cervic al length on transvaginal ultrasound, peripheral blood white blood cel l (WBC) count and C-reactive protein measurement, and cervical culture , were performed on two occasions during the pregnancy period, the fir st period being 8-12 weeks and the second period 18-22 weeks of gestat ion. Outcomes of these women (preterm or term delivery) were prospecti vely analyzed. Results: Twelve women (4.0% of total subjects) subseque ntly had preterm delivery and showed significantly shorter cervical le ngth (33.5 versus 39.5 mm, P = 0.015) and higher WBC count (9844 versu s 8404, P = 0.020) at 18-22 weeks of gestation than those with term de livery, Coexistence of shortening cervix (less than 30 mm) and positiv e cervical culture at 18-22 weeks of gestation were closely associated with the subsequent preterm delivery, the positive predictive value b eing 18.8% (odds ratio 6.9, 95% confidential interval: 1.9-24.5, P = 0 .023). Conclusions: Cervical change detected by transvaginal ultrasoun d accompanied with the presence of cervical microorganisms in midgesta tion is a good predictor for preterm delivery.