2 . 2019

Ultrasound criteria of perterm labor following fetal infection

Abstract

Aim. Study of possibilities of clinical, anamnestic, instrumental, and Laboratory data combination in preterm Labor (PL) risk prognosis caused by fetal infection in patients with threatened preterm labor.

Material and methods. Retrospective study of 134 patients with threatened preterm labor in 22-35 weeks of gestation. Routine ultrasound examination (US) with cervical length measurement (CL) was performed; additional thymic-thoracic ratio (TTR) was evaluated. Outcomes of pregnancies were taken into account: 1^st group - PL with verified chorioamnionities (n=39); 2^nd group - term delivery without clinical signs of intrauterine infection (n=95). Logistic regression was used for calculation of prognostic accuracy for PL for combinations of anamnesis data, risk factors for current pregnancy, clinical/laboratory signs of infection, preterm premature rupture of membranes (PPROM), US data.

Results. The use of multiple US-signs for prognosis of PL in patients with fetal infection was more accurate (AUC=0.886) than using the model considering clinical and laboratory signs of infection, anamnestic risk factors for PL and for current pregnancy (AUC=0.569), or the model additionally taking into account CL (AUC=0.648) and PPROM (AUC=0.835). The model combining TTR and PPROM had the maximal accuracy (AUC=0.894), maximal predictive value for positive test (91.4%) with high predictive value for negative test (92.9%).

Conclusion. Diagnostic value of ultrasound criteria in PL prognosis in patients with fetal infection and threatening PL surpasses the value of clinical, anamnesis and laboratory data. Accuracy of prognosis increases if PPROM takes place.

Keywords:preterm labor, chorioamnionitis, ultrasound examination, thymus, cervical lengt

For citation: Penzhoyan G.A., Makukhina T.B., Krivonosova N.V., Mingaleva N.V., Sykalchuk O.I., Penzhoyan M.A., Makukhina V.V. Ultrasound criteria of perterm labor following fetal infection. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2019; 7 (2): 42-50. doi: 10.24411/2303-9698-2019-12005. (in Russian)

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CHIEF EDITORS

Sukhikh Gennadii Tikhonovich

Academician of the Russian Academy of Medical Sciences, V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Moscow

Kurtser Mark Arkadievich

Academician of the Russian Academy of Sciences, MD, Professor, Head of the Obstetrics and Gynecology Subdepartment of the Pediatric Department, N.I. Pirogov Russian National Scientific Research Medical University, Ministry of Health of the Russian Federation

Radzinsky Viktor Evseevich

Corresponding Member of the Russian Academy of Sciences, MD, Professor, Head of the Subdepartment of Obstetrics and Gynecology with a Course of Perinatology of the Medical Department in the Russian People?s Friendship University

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