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The preterm cervix and preterm labor relative risks predictive values and change over time


, : The preterm cervix and preterm labor relative risks predictive values and change over time. American Journal of Obstetrics & Gynecology 155(4): 829-834

The accurate prediction and diagnosis of preterm labor continue to frustrate the clinician. This is partly due to a scarcity of cervical data from the early third trimester. A total of 760 prospective, serial, paired, and blinded pelvic examinations were done at 28 to 34 weeks of gestation for 191 patients without a history of preterm labor. If the cervix was dilated .gtoreq. 1 cm (internal os) or effaced > 30%, the relative risk of preterm labor was increased to 1.8 to 4.2. Negative predictive values for cervical status was > 92%, but positive predictive values were .ltoreq. 18%. Change over time was unusual (dilatation increase .gtoreq. 1 cm or effacement increase .gtoreq. 40%), suggesting that a baseline late second-trimester examination could assist in the early but accurate diagnosis of preterm labor should it be suspected later in gestation. These data suggest that even in the low-risk patient, an early cervical examination could be beneficial.

Accession: 006740115

PMID: 3766637

DOI: 10.1016/S0002-9378(86)80031-X

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