الفهرس 
I. INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Preterm delivery (PTD) as defined as the birth of an infant at less than 37
weeks of gestation. Given the significance of this clinical problem, a large
amount of time and energy has been dedicated toward prevention of preterm
birth. Preterm birth is the single largest cause of prenatal mortality and
morbidity in infants without anomalies in developed nations.Prematurity
remains a leading cause of neonatal morbidity and mortality in developed
countries, accounting for 60-80% of deaths of these infants.
This study was performed on eighty pregnant women attending the
antenatal care clinic of kafr El-dwar general Hospital. All have a singleton
pregnancy between 24 – 34 weeks gestation with no medical problem. They
were divided into two groups group one (fifty cases) and group two (thirty
cases) who have history of unexplained preterm labor.Then the patients
followed up for occurrence of preterm labor pain. All of them were exposed
to history taking,general, local examination in addition to special
investigations, which include cervical secretions sampling in order to measure
fibronectin levels and ultrasonographic examination to determine number,
viability, presentation, amniotic fluid index, cervical length, placental score
and gestational age.
The study showed that group with history of preterm labouratmore risk
of recurrence of preterm labor than other group. About placental score the study showed that there is no statistical
significance between groups.
About amniotic fluid index the study showed that asignificant statistical
difference was found between the groups. oligohydramnios have been
associated with an increased risk for preterm labor but not all patients with
oligohydramniosat risk of preterm labour.
About cervical length the study showed that asignificant statistical
difference was found between the groups. cervical length ≤25 mm develop
preterm labour The risk of spontaneous preterm delivery increased steeply as
cervical length decreased. About fetal fibronectin the study showed that asignificant statistical
difference was found between the groups. The detection of fetal fibronectin
concentrations of more than 50 ng/mL in the cervical or vaginal secretions has
been associated with anincreased risk of spontaneous preterm delivery.The
presence of FFN in cervical discharge does not necessarily indicate theonset
of labor and a negative result less than 50 ng/mL indicates a low likelihood of
delivery but a positive test should not be interpreted as an indication of labor
or a reason for admission .
About estimated date of delivery the study showed that asignificant
statistical difference was found between the groups. There was significant
correlation between estimated date of delivery and preterm labour patients.
About birth weight of newborn the study showed that asignificant
statistical difference was found between the groups. Lower birth weight in
preterm patient.
from the foregoing, the first step in prevention of preterm labor is early
identification of women at risk for preterm birth by the use of ultrasonography
for cervical length,amniotic fluid index and by the detection of fetal
fibronection (FFN) in cervicovaginal secretion.
Ultrasonographic assessment of cervical length and amniotic fluid
volume has a promising role to offer in the prediction of the risk of the
developing preterm labour. Considering the magnitude of preterm labour, cost
of management of preterm babies and morbidity- mortality associated with it,
the use of ultrasonographic assessment of cervical and amniotic fluid index at
24-34 weeks as routine screening method is an effective and can be offered to
all pregnant women.
The fetal fibronectin in cervical secretions can be used as a predictor
ofpreterm delivery.