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Introduction 2 Clinical predictors of preterm delivery 2.1 Cervical change PAPIERNIK and colleagues observed evidence of cervical change by 38 weeks in 30% of 8303 women studied [48]. They also noted that the interval between the detection of cervical change and delivery was similar regardless of the gestational age at birth [48], suggesting that the same pattern of cervical change precedes both preterm and term labor. Cervical change was frequently associated with symptomatic uterine contractions and vaginal bleeding. However, after controlling for these other risk factors, cervical dilatation > 1 cm was associated with an elevated adjusted relative risk for PTD (2.4-3.4) [48]. Given the absence of confounding tocolytic therapy, this longitudinal study provides crucial data on the natural history of cervical change and its value as a predictor of PTD. STUBBS et al. conducted serial, paired and blinded pelvic examinations on 191 low risk patients with singleton gestations between 28 and 34 weeks [60]. They found minimal differences in mean cervical dilatation, cervical effacement and fetal station between nulliparous and parous patients. The maximal cervical dilatation between 28 and 34 weeks in patients delivering at term was 3 cm but only 6.4% of patients delivering at term
Journal of Perinatal Medicine – de Gruyter
Published: Jan 1, 1993
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