Two Methods of Diagnosing Preterm Labor

Randomized Controlled Trial of Two Methods of Diagnosing Preterm Labor

Use of modern diagnostic tools e.g. fetal fibronectin and ultrasound measurement of cervical length to diagnose preterm labor can result in improved outcomes compared to traditional diagnosis based on digital examination to measure cervical change.

Symptomatic preterm labor patients will be randomized to diagnosis of preterm labor by serial digital examination versus an algorithm incorporating transvaginal ultrasound measurement of cervical length and vaginal fetal fibronectin.

Inclusion Criteria:

• symptomatic complaints suggestive of preterm labor
• greater than 6 contractions per hour

Exclusion Criteria:

• multiple gestation
• rupture of amniotic membranes
• chorioamnionitis
• congenital malformations
• persistent vaginal bleeding
• abruptio placentae
• placenta previa
• previously diagnosed short cervix < 2.5 cm
• cervical dilation > 3 cm
• cervical cerclage
• exposure to tocolytic drugs
• allergy or contraindication to nifedipine