الفهرس 
PathophysiologyOnly 14 pages are availabe for public view
 |  | from | 218 |  |  |
| | | from | 218 | | |
Abstract
Preterm birth is one of the major clinical problems in obstetrics and neonatology as it is associated with perinatal mortality, serious neonatal morbidity and in some cases childhood disability. It is reported that more than 80% of all neonatal mortality and morbidity is due to preterm birth.
In this study β-hCG value in cervical secretion was used as a predictive marker for preterm labor. The study was carried out at Ain Shams University Maternity Hospital. The current study include 90 pregnant women who presented with threatened preterm labor (PTL) were included as group I [Threatened PTL Group], along with 300 healthy pregnant women, matching the first group regarding age and gestational age(24-34 weeks), included as group II [Control Group]. All women were subjected to full history taking, full general, abdominal, pelvic examination, in addition to estimation of β-hCG in cervicovaginal secretions qualitatively and quantitatively.
The patients were followed up till delivery if they were get into evident preterm labor or complete the pregnancy. According to gestational age at delivery, patients were divided into 4 subgroups; subgroup Ia :[women with threatened PTL who delivered preterm (n=32) ], subgroup Ib: [women with threatened PTL who delivered at term (n=58)], subgroup IIa: [control Women who delivered preterm (n=28) ] and subgroup IIb: [ control women who delivered at term (n=272)].
The β-subunit of HCG in cervicovaginal secretions was found to be higher in women who delivered preterm compared with women who complete them pregnancy and the proportion of women who had positive cervicovaginal β-hCG assay was significantly higher among women who delivered preterm when compared to women who delivered at term in both groups.
The qualitative test was found to have sensitivity , specificity, PPV, NPV and diagnostic accuracy to predict PTB of 68.33%, 96.06%, 75.93%, 94.35% and 91.79% respectively, it was found to be more sensitive in the high risk patients, but more specific in the low risk control group the performance of the quantitative test at its best cut-off value i.e.34.5 mIU/m, was found to be better than the qualitative test.