The value of maternal serum progesterone and cholesterol levels and cervical transvaginal gray-scale histogram in predicting preterm birth in high-risk women

Abstract

Background Preterm labor (PTL) is a challenging gynecological problem that is accountable for high rates of perinatal mortality and morbidity. Low maternal serum cholesterol and progesterone levels are associated with preterm birth. Measurement of cervical length, funneling, and consistency are essential in screening for PTL. Objective The aim of the study was to show a correlation between maternal serum progesterone and cholesterol levels and cervical transvaginal gray-scale histogram at 20–25 weeks in the prediction of preterm birth in high-risk women. Patients and methods The study included 100 patients at high risk for PTL attending Minia Maternity University Hospital. Levels of progesterone and cholesterol were analyzed and a cervical transvaginal histogram to determine cervical glandular/stromal ratio was performed for all patients at 20–25 weeks of gestation. Results PTL occurred in 30 of 100 women. Increased incidence of spontaneous PTL was seen in patients with a short cervix and increased funneling. Serum progesterone was significantly (P=0.001) lower in women who delivered preterm (80.6±27.5) compared with women who delivered at term (116.1±15.8). Also, serum cholesterol was significantly (P=0.001) lower in women who delivered preterm (156.6±35.4) than in women who delivered at term (185.6±42.3). Glandular/stromal ratio was significantly lower (P<0.001) in women who delivered preterm (0.31±0.04) than in those who delivered at term (0.98±0.02). Conclusion Glandular/stromal ratio, serum progesterone and cholesterol levels, and transvaginal ultrasound findings can predict PTL in high-risk women. They can also be used for prevention of PTL.