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PREDICTION OF PRETERM DELIVERY IN PREGNANT WOMEN WITH THREATENED PRETERM LABOR USING TRANSVAGINAL ULTRASOUND AND NEUTROPHILS TO LYMPHOCYTES RATIO

Accept Date 2019-07-13 ABSTRACT Background: Preterm labor is defined as regular contractions of the uterus resulting in changes in the cervix that start before 37 weeks of pregnancy. It contributes directly to estimated one million neonatal deaths annually and is a significant contributor to childhood morbidity. Prediction of preterm labor could contribute to reduction in neonatal morbidity and mortality. Aim of the work: The aim of this study is to compare the level of neutrophil/leucocyte ratio (NLR) and C-reactive protein (CRP) between preterm and term patients and to show whether those inflammatory markers either alone or in combination with cervical length via transvaginal ultrasound are useful for prediction of spontaneous preterm delivery in patients with threatened preterm labor. Patients and methods: This is a prospective study that was conducted at Zagazig University Hospitals. It included 90 women, 60 with threatened preterm labor, and 30 healthy pregnant women at term. Results: Markers combination (neutrophil/leucocyte ratio (NLR), C-reactive protein (CRP) and cervical length by transvaginal sonography) is the best predictor for preterm labor in patients with threatened preterm labor with sensitivity and specificity (94.7 and 86.7; respectively) with high accuracy (95.5%). Conclusion: Findings of this study demonstrated that the combined marker is more sensitive & specific for predicting spontaneous preterm delivery in pregnant women with threatened preterm labor in comparison with cervix length, NLR, CRP alone. The combined marker is cost-effective test as it is based on leucocyte counts & cervical length which already investigated in patients with threatened preterm labor.