Doppler Ultrasound assessment as a predictor of Preterm Labor in Pregnant Women with Threatened Preterm Labor

Abstract

Introduction: Threatened preterm delivery is the most common diagnosis that leads to hospitalization during pregnancy. Although at least half of women admitted for threatened preterm labor will eventually deliver at term, nearly 20% of symptomatic women who are diagnosed as not being in preterm labor will deliver prematurely.while pre-eclampsia and foetal growth restriction (FGR) can be identified as other common causes that could lead to such complications. Objective: To assess the value of doppler ultrasound  in preterm labor in pregnant women with threatened preterm labor.Methods:A single-center cohort study was carried out at Obstetrics and Gynecology, 250 bededhospital, Gopalgonj, Bangladesh from January to December 2022. Total 100 women were selected for the present study after applying inclusion and exclusion criteria. All participating women signed informed written consent. The study included singleton pregnant women who present to the casualty at gestations between 28 and 34 weeks of gestation with symptoms and signs of threatened preterm labor (defined as presence of at least one uterine contraction per 10 minutes, lasting at least 30 seconds, with a cervical dilatation ≤ 3 cm, and a cervical effacement < 80%). On admission, during obstetric ultrasound scanning, bilateral uterine artery Doppler ultrasound velocimetry was performed using the transabdominal technique. Results:Total 100 women presenting with threatened preterm labor were included in the study. The mean age of included women was 32.19 ± 5.14 years (range: 24-41 years). The median parity was 2 (range: 0-4; interquartile range: 1–3). The mean body mass index (BMI) was 27.37± 4.7kg/m² (range: 17.58–39.19 kg/m²). The mean gestational age at presentation was 30.86 ± 1.71 weeks (range: 28-33.86 weeks). Of the included 141, 38 (38%) delivered within 7 days, while 62 (62%) delivered after 7 days of presentation. The mean uterine artery pulsatility index (UA-PI) measured both basally and at the peak contraction were significantly higher among women who delivered within 7 days. ROC curves showed that both basal and contraction UA-PI were significant predictors of delivery within 7 days. There was a significant negative correlation between contraction UA-PI and birth weight. Conclusion: Uterine artery Doppler ultrasound velocimetry measured in women with threatened preterm labor, seems to be a significant predictor of actual preterm labor within 7 days of admission.