Archives of Gynecology and Obstetrics

, Volume 285, Issue 1, pp 31–35

Raised electrical uterine activity and shortened cervical length could predict preterm delivery in a low-risk population

Materno-Fetal Medicine

DOI: 10.1007/s00404-011-1906-x

Cite this article as:
Grgic, O., Matijevic, R. & Kuna, K. Arch Gynecol Obstet (2012) 285: 31. doi:10.1007/s00404-011-1906-x

Abstract

Purpose

To compare diagnostic accuracy of sonographic cervical length (CL) measurement and uterine electric activity assessed by electromyography (EMG) in second trimester regarding prediction of preterm delivery (PTD).

Methods

Prospective study of 308 low-risk women. Shortened CL was defined as ≤25 mm (≤5th centile), while raised EMG activity was defined as the presence of ≥20 action potentials in 20 min of assessment (≥95th centile). Outcome measures were diagnostic accuracy of both tests alone or in combination for prediction of PTD and early PTD (≤34 weeks).

Results

The incidence of PTD was 23/308 (7.4%) while the incidence of early PTD was 9/308 (2.9%). Shortened CL and raised EMG activity were significantly related to PTD [prevalence-weighted likelihood ratio (pw-LR) 1.9, 95% CI 1.0–3.5 vs. 9.5, 95% CI 2.5–35.7], but not to early PTD (pw-LR 0.4, 95% CI 0.2–0.8 vs. 0.6, 95% CI 0.3–1.7). Significant predictive value for early PTD was found only if both tests were combined (pw-LR 4, 95% CI 1.3–14.3).

Conclusion

Shortened CL and raised EMG activity in second trimester have significant diagnostic accuracy regarding prediction of PTD in a low-risk population. However, in order to be useful as a predictor for early PTD both tests must be positive.

Keywords

Cervical lengthLow-risk populationSecond trimesterPreterm deliveryTransvaginal ultrasoundUterine electromyographic activity

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.University Department of Obstetrics and GynecologyUniversity Hospital Sestre MilosrdniceZagrebCroatia
  2. 2.University Department of Obstetrics and GynecologySchool of Medicine, Sveti Duh HospitalZagrebCroatia