Prediction and Prevention of Expected Preterm Birth

Abstract

 The aim of the study was to predict the development of preterm birth using simple, reliable, and accessible transvaginal ultrasonography at 18-24 weeks of pregnancy, monitor cervical length, and develop tactics for implementing adequate preventive measures. Clinical observation was conducted on the course of pregnancy and birth in 157 women. Risk factors with high prognostic value for preterm birth include one or more preterm births in the history with singleton pregnancy. For predicting expected preterm birth, we used an accessible and simple method of transvaginal ultrasonography, accurate, scrupulous determination of cervical length at 18-24 weeks of pregnancy every 2 weeks, with cervical length ≤ 25mm as the threshold for initiating treatment. Adequate preventive measures included minimal interventions - vaginal progesterone from 18 to 35 weeks and cervical cerclage up to 24 weeks of pregnancy in cases of cervical shortening ≤ 25mm. Thus, these simple, accessible, technically correctly performed preventive measures significantly reduced the frequency of preterm births, particularly up to 32 weeks of pregnancy.