Cervical examination and tocodynamometry at 28 weeks' gestation: prediction of spontaneous preterm birth.
OBJECTIVE
We determined the value of cervical examination and tocodynamometry in identifying nulliparous women at risk for spontaneous preterm delivery.


METHODS
At 27.5 +/- 0.8 weeks' gestation 589 women underwent 30 minutes of tocodynamometry, and 570 of these had a cervical examination. Positive findings on these examinations were compared to the rate of spontaneous preterm delivery, defined as those deliveries following the onset of spontaneous labor or premature rupture of membranes.


RESULTS
The two best predictors of spontaneous preterm birth were two or more contractions in 30 minutes and the presence of a soft or medium consistency on cervical examination. As the contractions increased from zero to four or more, the rate of spontaneous preterm delivery rose from 4.2% to 18.2%.


CONCLUSIONS
In nulliparous women at 28 weeks' gestation, uterine contractions and several components of the cervical examination predicted spontaneous preterm birth.
Department of Obstetrics and Gynecology, University of Alabama at Birmingham, 35233-7333.
R L
RL
Copper
R L
RL
Goldenberg
M B
MB
Dubard
J C
JC
Hauth
G R
GR
Cutter
D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007752:Obstetric Labor, Premature / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D012680:Sensitivity and Specificity; D018590:Uterine Monitoring