title: Significance of cervical gland area in predicting preterm birth for patients with threatened preterm delivery: comparison with cervical length and fetal fibronectin.
abstract: OBJECTIVE
  Absent cervical gland area (CGA) has been considered a predictor of preterm delivery (PTD) for women at low risk. Predictive efficacy was analyzed in women at high risk for PTD and compared with cervical length (CL) <20 mm and fetal fibronectin (fFN) in cervicovaginal secretions.
  
  
  METHODS
  Case notes were reviewed for 108 subjects with gestation of 22-33 weeks who had been admitted to hospital with threatened PTD. The uterine cervix was observed by vaginal sonography and fFN was sampled on admission. Relationships between findings and outcome of PTD at <34 weeks' gestation were analyzed.
  
  
  RESULTS
  Delivery at <34 weeks' gestation occurred in 14.8% of patients. Absent CGA (68.8%), short CL (75.0%), short CL without CGA (62.5%) and positive fFN (62.5%) were more frequent in these patients than in patients undelivered at <34 weeks' gestation (p < 0.05). Logistic regression analysis identified positive fFN and short CL with absent CGA as independent predictors for PTD (p < 0.0001). The mean interval from admission to delivery was 2.9 weeks in cases with fFN and both sonographic findings, compared to 9.3 weeks in cases with fFN but both sonographic finding (p = 0.0005).
  
  
  CONCLUSIONS
  Short CL with absent CGA represents an independent predictor for PTD, as does fFN.
authors.affiliation: Department of Obstetrics and Gynecology, Nippon Medical School, Musashikosugi Hospital, Kawasaki City, Kanagawa, Japan. morgen@nms.ac.jp
authors.forename: Hirobumi
authors.initials: H
authors.lastname: Asakura
authors.forename: Takehiko
authors.initials: T
authors.lastname: Fukami
authors.forename: Ryuhei
authors.initials: R
authors.lastname: Kurashina
authors.forename: Naoko
authors.initials: N
authors.lastname: Tateyama
authors.forename: Daisuke
authors.initials: D
authors.lastname: Doi
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Takeshita