Uterine Artery Doppler Ultrasound Measurement of Preterm Labor in Pregnant Women with Threatened Preterm Labor

Abstract

Introduction: One of the most common causes of hospitalisation during pregnancy is preterm labour. Nearly one-fifth of women hospitalised for preterm labour. The frequency of preterm births is about 12%–13% in the USA and 5%–9% in many other developed countries. One of the main causes of preterm delivery is preterm premature rupture of membranes, 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 uterine artery doppler ultrasound measured of preterm labor in pregnant women with threatened preterm labor. Methods: We performed a single-center cohort study was carried out at Obstetrics and Gynecology, Sylhet MAG Osmani Medical College Hospital & Jalalabad Clinic, Modhushohid, Sylhet, Bangladesh from January to December 2020. Total 141 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. Uterine artery Doppler scans were both conducted at the peak of uterine contraction and in between contractions when the uterus is fully relaxed. Results: Total 141 women presenting with threatened preterm labor were included in the study. The mean gestational age at presentation was 30.86 ± 1.71 weeks (range: 28 – 33.86 weeks). Among 45 (31.9%) delivered within 7 days, while 96 (68.1%) 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.