OC013: Impact of ultrasound cervical length assessment on duration of hospital stay in the clinical management of threatened preterm labor

Abstract

To evaluate the impact of ultrasound cervical length measurement on duration of hospital stay in patients admitted for threatened preterm labor. Prospective comparative study in 294 patients with threatened preterm labor in three hospitalization units (A, B and C). In the first phase of the study (observational), cervical length was measured by transvaginal ultrasound, but managing physicians were blinded to results. In the second phase (interventional), physicians from unit A remained blinded to cervical length information, but units B and C incorporated this data into their clinical management protocols. Early discharge was contemplated if the cervix measured 25 mm or more on admission (unit B) or no changes were observed over 48 hours (unit C). Duration of hospital stay and delivery rates within 7 days, and before 34 and 37 weeks' gestation were recorded. Hospital stay was significantly reduced in units B and C in the interventional phase, while no changes were observed in unit A. In group A there were no significant differences between the observational and interventional phases (6.1 [SD 3.7] vs. 5.1 [3.1] days, P = 0.214). However, in groups B and C mean duration of hospital stay was reduced by about two days (6.4 [SD 3.5] vs. 3.8 [1.6], P = 0.005, and 5.8 [2.7] vs. 3.7 [1.6], P = 0.003, respectively). Delivery rates within 7 days, 34 and 37 weeks were similar in the three units during the two stages of the study. Routine use of ultrasound cervical length assessment in patients admitted with threatened preterm labor may reduce the duration of hospital stay without increasing the rate of preterm births.