Threatened Preterm Labor Clinical Trial
Official title:
Maternal Serum Level of ACTH as a Predictive Marker of Preterm Labor in Patients With Threatened Preterm Labor
The aim of this study is use of ACTH as a predictive marker in patients of threatened preterm labor .
This is a cross sectional study that will include 261 pregnant women aged between 17 and 35
years with singleton pregnancies between 28 and 36 completed weeks of gestation that had
been diagnosed with threatened preterm labor and consented to participate in this study.
This study will be conducted at Ain Shams University Maternity Hospital after approval of
the research and ethics committee.
the investigators include all patients which have these following criteria (Singleton
pregnancy, Age between 17 - 35 years, Gestational age between 28 and 36 weeks and Diagnosis
of threatened preterm labor is based on the American College of Obstetricians and
Gynaecologists Guidelines (ACOG, 2003): Presence of uterine contractions (at least 4 in 20
minutes or 8 in 60 minutes), Cervical dilation > 1 and < 4 cm, and/or Cervical effacement ≥
80%.
the investigators exclude any patient which has any of the following criteria (Preterm
rupture of membranes, Any uterine anomalies or cervical incompetence, Chronic illness such
as chronic hypertension or kidney disease, Diabetes mellitus, Abruptio placenta,
Preeclampsia and HELLP syndrome, Fetal anomalies, IUGR, Smoking or Clinical signs of
intrauterine infection).
blood sample was collected from each patient for measurement of ACTH level. According to
local protocol in Ain Shams University Maternity Hospital all women will receive a fixed
regimen of tocolysis in the form of nifedipine (Epilat) 10 mg orally every 15 minutes for
the first hour or until cessation of uterine contractions. Then, 60 - 160 mg/day (1-2
tablets 3 times daily) of slowly releasing nifedipine (epilat retard 20 mg tablet) may be
given depending on uterine activity. The patients will also receive 6 mg dexamethasone every
12 hours for 4 doses. All women will be followed up till delivery.
After delivery, the investigators divide the patients into 2 groups (full term delivery &
preterm delivery) and we compare between these 2 groups by level of hormone.
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Observational Model: Case-Only, Time Perspective: Cross-Sectional
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