Prediction of preterm labor:
Fetal fibronectin:
It is a glycoprotein maintaining intercellular adhesion during implantation and placental adhesion to decidua.
Fetal fibronectin level of > 50 ng/ml in cervico vaginal secretions between 24 to 37 wks of gestation suggest impending preterm labor.
False positives found :
if amniotic fluid gets contaminated with blood, semen, in women with circlage, ROM (rupture of membrane), preeclampsia, after cervical manipulation, endovaginal ultrasound , speculum or digital examination.
Has high negative predictive value.
Cervical assessment by trans vaginal ultrasound:
By using trans vaginal ultrasound, length of endocervical canal, length of funnel, width of internal os, cervical index can be measured.
Risk of preterm labor is inversely proportional to cervical lenth between 24 to 28 wks.
Mean cervical length is – 3.5cms.
If length is > 2.5cm - 3% chances of preterm labor is there.
If length is <2.5cm – chance increases to 35%.
Salivary estriol:
Detection of an early estriol surge or increased level (> or = 2.3 ng/ml) may be clinically helpful in identifying women at elevated risk for preterm labor and birth.
Phosphorylated insulin-like growth factor-binding protein-1 (phIGFBP-1):
It is a protein secreted by decidual cells, which leaks into cervical secretions when fetal membranes detach from the decidua before the onset of labor.
Vaginal identification of phIGFBP-1 has been proposed as an option in predicting preterm delivery in symptomatic patients.
Cytokines levels:
The membrane cytokine response mirrors that documented in the amniotic fluid during intraamniotic infection (IAI).
Inflammatory cytokines (IL-1, IL-6 and TNF) cause the release of compounds (prostaglandins) which cause the uterus to contract, this leads to preterm labor.
Preterm labor-etiologicalfactors
Preterm labor-pathogenesis and diagnosis
Preterm labor-investigations
Preterm labor-prediction
Preterm labor-complications
Preterm labor -prevention
Preterm labor-bacterialvaginosis
Preterm labor-progesterone.html
Preterm labor-cervical circlage
Pretem labor-management
Preterm labor-tocolytics
Preterm labor-with premature rupture of membranes
Fetal fibronectin:
It is a glycoprotein maintaining intercellular adhesion during implantation and placental adhesion to decidua.
Fetal fibronectin level of > 50 ng/ml in cervico vaginal secretions between 24 to 37 wks of gestation suggest impending preterm labor.
False positives found :
if amniotic fluid gets contaminated with blood, semen, in women with circlage, ROM (rupture of membrane), preeclampsia, after cervical manipulation, endovaginal ultrasound , speculum or digital examination.
Has high negative predictive value.
Cervical assessment by trans vaginal ultrasound:
By using trans vaginal ultrasound, length of endocervical canal, length of funnel, width of internal os, cervical index can be measured.
Risk of preterm labor is inversely proportional to cervical lenth between 24 to 28 wks.
Mean cervical length is – 3.5cms.
If length is > 2.5cm - 3% chances of preterm labor is there.
If length is <2.5cm – chance increases to 35%.
Salivary estriol:
Detection of an early estriol surge or increased level (> or = 2.3 ng/ml) may be clinically helpful in identifying women at elevated risk for preterm labor and birth.
Phosphorylated insulin-like growth factor-binding protein-1 (phIGFBP-1):
It is a protein secreted by decidual cells, which leaks into cervical secretions when fetal membranes detach from the decidua before the onset of labor.
Vaginal identification of phIGFBP-1 has been proposed as an option in predicting preterm delivery in symptomatic patients.
Cytokines levels:
The membrane cytokine response mirrors that documented in the amniotic fluid during intraamniotic infection (IAI).
Inflammatory cytokines (IL-1, IL-6 and TNF) cause the release of compounds (prostaglandins) which cause the uterus to contract, this leads to preterm labor.
Preterm labor-etiologicalfactors
Preterm labor-pathogenesis and diagnosis
Preterm labor-investigations
Preterm labor-prediction
Preterm labor-complications
Preterm labor -prevention
Preterm labor-bacterialvaginosis
Preterm labor-progesterone.html
Preterm labor-cervical circlage
Pretem labor-management
Preterm labor-tocolytics
Preterm labor-with premature rupture of membranes
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