Combination of selected biochemical markers and cervical length in the prediction of impending preterm delivery in symptomatic patients

Abstract

The pathophysiology of preterm delivery (PTD) is complex and multifactorial. It occurs in 8-12% of all deliveries, and the rate of PTD has increased during the past years in spite of intensive efforts towards early detection and prompt treatment. Fifty-eight pregnant women were eligible to join the study if they attended the University Clinic for Gynecology and Obstetrics, Skopje and were admitted to Department of High Risk pregnancy Unit with symptoms of preterm labor (PTL) (symptoms of uterine activity judged by the assessing physician to be indicative of PTL) at 24.0 to 36.6 weeks gestation.Test specimens for fetal fibronectin (fFN), phosphorylated insulin like growth factor binding protein 1 (phIGFBP-1), IL-6, and IL-2R and measuring the cervical length via transvaginal ultrasound were performed for each patient. The best statistical model for predicting PTL in the present study was to use a combination of the phIGFBP-1 test, a positive fFN test, cervical length less than 21.5mm, levels of IL-6 higher than 1,305 pg/ml in the cervico-vaginal fluid (CVF), and serum levels of C-reactive protein (CRP) higher than 6.1mg/L which was excellent at identifying the patients that were to deliver within 14 days of admittance.