만삭 단태임신의 분만일 예측과 관련된 초음파 인자

김광준 ( Gwang Jun Kim ),이은실 ( Eun Sil Lee ),이우석 ( Woo Seok Lee ),이상훈 ( Sang Hoon Lee ),장영진 ( Young Jin Jang ),김동호 ( Dong Ho Kim ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.7

목적: 본격적인 분만 진통 시작 전에 자궁근육과 자궁경부는 생화학적, 형태적 변화를 겪게 된다. 초음파 검사를 통해 이러한 형태적 변화 양상을 관찰함으로 실제 분만일과 연관된 인자를 찾고, 나아가 분만일의 예측이 가능한 지 알아보고자 하였다. 연구 방법: 재태기간 36주가 지난 단태임신 산모 61명을 대상으로 자연 진통에 따른 질식 분만을 하기까지 매주 초음파 검사를 시행하여 자궁하절부의 두께, 자궁경부의 길이, 자궁경관선의 두께와 양수지수를 측정하여 분만까지 남은 날과의 상관관계를 분석하였다. 대상 산모중 태아 기형이나 양수의 이상, 자궁하절부에 자궁근종이나 하위 태반이 존재하는 경우는 제외하고 52명을 최종 분석대상으로 하였다. 결과: 재태기간에 따라 자궁하절부의 두께, 양수지수, 자궁경부의 길이는 점차 감소하는 경향을 보였지만 통계적 유의성은 없었다. 초음파로 측정한 4가지 분만 연관 요인 중에서 자궁경부 길이가 측정일로부터 분만까지 남은 날을 예측하는데 통계적인 유의성을 보였으며 다음과 같은 수식으로 나타낼 수 있었다. 측정일에서 분만까지 남은 일수=6.12+0.24×자궁경부길이 (㎜) (r=0.29, p<0.01) 결론: 재태기간 36주 이후의 단태임신 산모에서 자궁경부길이의 초음파 측정은 측정일로부터 분만일까지의 남은 일 수와 관련이 있었다. Objective: The aim of this study was to find out the relating factors with the actual delivery day in term singleton pregnancy. Methods: The 52 patients with singleton gestation were visited weekly and measured for their lower uterine segment (LUS) thickness, cervical length and cervical gland thickness by transvaginal ultrasonography and for amnionic fluid index (AFI) by transabdominal ultrasonography from 36 weeks of gestation until birth. Regression analysis was used to find out the relevance between these factors and remaining days to birth. Resullts: There was a significant relationship between cervical length and remaining days to birth in term pregnancy, which could be described as a mathematical equation (remaining days for delivery=6.12+0.24×cervical length (㎜) r=0.29, p<0.01). However, no relationship was found between factors such as LUS, AFI, and cervical gland thickness and remaining days to birth. Conclusion: Our results suggest that the actual delivery day in term singleton pregnancy might be predicted with cervical length.

Progesterone Treatment for Prevention of Preterm Birth

( Hyun-joo Seol ),( Suk Joo Choi ),( Soo-young Oh ) 대한주산의학회 2016 Perinatology Vol.27 No.4

Preterm birth is the main cause of neonatal mortality and morbidity worldwide. Although many attempts and clinical trials have conducted to prevent preterm birth during the past decades, no convincing strategy was developed so far. In this background, there is no doubt that the research area under the spotlight in recent ten years was about progesterone treatment in women at high risk for preterm birth including prior preterm birth and short cervical length. This rigorous review aimed to provide the most updated knowledge on progesterone treatment for the prevention of preterm birth for physicians and included the history and the proposed mechanism of progesterone treatment, summary of clinical trials of progesterone treatment in singleton and twin gestation with prior spontaneous preterm birth and short cervical length, respectively. It also adduces long term outcomes in infants whose mother exposed to progesterone treatment during pregnancy and presents current evidence on comparison between intramuscular versus vaginal progesterone for the prevention of recurrent preterm birth.

Artificial Neural Network Analysis of Spontaneous Preterm Labor and Birth and Its Major Determinants

이광식,안기훈 대한의학회 2019 Journal of Korean medical science Vol.34 No.16

Background: Little research based on the artificial neural network (ANN) is done on preterm birth (spontaneous preterm labor and birth) and its major determinants. This study uses an ANN for analyzing preterm birth and its major determinants. Methods: Data came from Anam Hospital in Seoul, Korea, with 596 obstetric patients during March 27, 2014 - August 21, 2018. Six machine learning methods were applied and compared for the prediction of preterm birth. Variable importance, the effect of a variable on model performance, was used for identifying major determinants of preterm birth. Analysis was done in December, 2018. Results: The accuracy of the ANN (0.9115) was similar with those of logistic regression and the random forest (0.9180 and 0.8918, respectively). Based on variable importance from the ANN, major determinants of preterm birth are body mass index (0.0164), hypertension (0.0131) and diabetes mellitus (0.0099) as well as prior cone biopsy (0.0099), prior placenta previa (0.0099), parity (0.0033), cervical length (0.0001), age (0.0001), prior preterm birth (0.0001) and myomas & adenomyosis (0.0001). Conclusion: For preventing preterm birth, preventive measures for hypertension and diabetes mellitus are required alongside the promotion of cervical-length screening with different guidelines across the scope/type of prior conization.

치료적 자궁경관봉축술후 질초음파단층법을 이용한 자궁 경관의 길이 변화와 만삭 임신의 예측

이윤이(Yun Ee Rhee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.6

N/A Objective : To determine the change in cervical length after cerclage and whether a transvaginal ultrasonographic measurement about change in cervical lengthening after cerclage is predictive of term delivery Methods : Twenty-nine single pregnant women were suspected as cervical incompetence by using a serial transvaginal ultrasonography. When a shortening of the cervix was substantial before 25 weeks' gestation, a therapeuric McDonald cerclage was applied. The 29 pregnant women had a transvaginal ultrasonographic measurement of the cervix within 48-72 hours before and after cerclage. At each examination, the first measurement was discarded, and the mean of the subsequent three measurements was calculated. Statistical analysis was performed by use of SAS with the significance set at the 5% level. Results : In the 29 single pregnancies examined, the mean cervical length (distance between internal os and external os) before cerclage was 30.0±4.5 mm. A cerclage was applied at the mean gestational age of 16.76±3.02 weeks. After the cerclage the mean cervical length increased significantly (r=0.895, p=0.0001) to 34.1±4.5 mm. There was a significant relation between the gestational age at delivery and the length of postoperative upper cervix (endocervical canal length above suture) (r=0.378, p=0.043). But there was no significant relation between the gestational age at delivery and the following measurements; preoperative cervical length (r=0.348, p=0.064), postoperative cervical length (r=0.279, p=0.143), cervical lengthening (postoperative cervical length - preoperative cervical length) (r=-0.156, p=0.420), length of postoperative lower cervix (endocervical canal length below suture) (r=-0.003, p=0.999). Conclusion : Therapeutic McDonald cerclage results in a longer cervical length as measured by transvaginal ultrasonography. The increase in cervical length after cerclage is not a predictive term delivery. But the Length in upper cervix after cerclage correlated with gestational weeks at delivery

조산 예측인자로서 Fetal Fibronectin과 자궁경부 개대 및 길이 측정의 임상적 의의

정두용,방세창,유정현,김소정 건국대학교 의과학연구소 1999 건국의과학학술지 Vol.9 No.-

Twenty seven pregnant women between 22 and 36 weeks of gestational age presenting with preterm labor, intact membrane and less than 3cm cervical dilatation visited the department of Obstetrics and Gynecology, KonKuk University Medical Center, Choongju Hospital from June 1, 1998 to March 31, 1999. These patients' cervicovaginal swabs were assessed for the presence or absence of fetal fibronectin by means of ROM-CHECK(monoclonal antibody assay) the positivity of which was revealed by a colorimetric reaction. Also cervical parameters such as cervical length, presence of funneling, funnel length and funnel width were measured by transvaginal ultrasonography. We compared the diagnostic performances of these results in the prediction of preterm delivery of patients with preterm labor and intact membranes. The results were as follows; 1. The overall incidence of preterm delivery(< 37 weeks) was 44%; 12 among 27 patients. 2. There were statistically significant differences in the mean Bishop scores(4.58±0.48 vs 2.13±0.36), the mean gestational age at first admission with preterm labor(33.33±0.38 vs 29.47±1.06 weeks), the mean gestational age at delivery(34.92±0.34 vs 38.27±0.34 weeks) and interval from first admission to delivery(284.2±103.1 vs 1,339.2±154.4 hour) and mean birthweight(2,620±100 vs 3,131±100g) between the preterm delivery group and term delivery group. 3. The positive rates of fetal fibronectin in the vaginal fluid of preterm delivery group and term delivery group were 42%(5/12) and 0%(0/15). 4. The mean cervical length, presence of cervical funneling, funnel length and funnel width were 22.25±2.61mm vs 30.67±1.63mm; 75%(9/12) vs 47%(7/15); 11.83±3.40mm vs 4.53±1.64mm; 11.50±2.92mm vs 6.07±1.87mm in preterm delivery group and term delivery group, and there were statistical significances in the mean values of cervical length and funnel length between each group. 5. The sensitivities and specificities of fetal fibronectin, cervical length(≤25mm), cervical funnel length(≥10mm) and width(≥16mm) as a predictor of preterm delivery were 42% and 100%; 75% and 80%: 50% and 87%; 33% and 93%. The positive predictive values and negative predictive values of fetal fibronectin, cervical length(≤25mm), cervical funnel length(≥10mm) and funnel width(≥16mm) as a predictor of preterm delivery were 100% and 68%; 75% and 80%; 75% and 68%; 80% and 64%. 6. The sensitivities and specificities of the combined use of fetal fibronectin, cervical length(≤25mm), cervical funnel length(≥10mm) and width(≥16mm) as a predictor of preterm delivery were 83% and 67%. The positive predictive value and negative predictive value of the combination of fetal fibronectin, cervical length(≤25mm), cervical funnel length(≥10mm) and width(≥16mm) as a whole as a predictor of preterm delivery were 67% and 83%.

Post-cerclage ultrasonographic cervical length can predict preterm delivery in elective cervical cerclage patients

( Rok Katerina Song ),( Hyun Hwa Cha ),( Mi Young Shin ),( Suk Joo Choi ),( Soo Young Oh ),( Jong Hwa Kim ),( Cheong Rae Roh ) 대한산부인과학회 2016 Obstetrics & Gynecology Science Vol.59 No.1

Objective To evaluate the usefulness of transvaginal ultrasound measurements of cervical length before and after elective prophylactic cervical cerclage in predicting preterm delivery before 32 weeks of gestation. Methods Women who underwent an elective cerclage operation at 14 to 19 weeks of gestation and who delivered between January 2004 and December 2009 were enrolled in this study (n=52). Ultrasonography was performed to measure cervical length before and after cerclage. The primary outcome was defined as preterm delivery before 32 weeks of gestation. A receiver operating characteristic curve was used to determine the most discriminating cut-off values of ultrasonographic cervical parameters predictive of preterm delivery before 32 weeks of gestation. Results Among the 52 patients studied, ten delivered before 32 weeks of gestation. Among the ultrasonographic cervical parameters compared, only the cervical length after cerclage was significantly different (shorter) in patients who delivered before 32 weeks of gestation (P=0.037) compared to that of those who delivered after 32 weeks of gestation in univariate and multivariate analyses (odds ratio, 0.402; 95% confidence interval, 0.174 to 0.925; P=0.021). The receiver operating characteristic curve showed that a cervical length of 25 mm or less after cerclage was predictive of preterm delivery before 32 weeks of gestation (area under curve, 0.71; 95% confidence interval, 0.56 to 0.87; P=0.029) with a sensitivity of 91.0% and a specificity of 30.0%. Conclusion Patients with a cervical length less than 25 mm after elective cerclage may be at higher risk of preterm delivery before 32 weeks of gestation.

임신 38주 초음파검사에 의한 일주일 이내의 분만가능성 예측

노현경 ( Hyun Kyung Rho ),이선경 ( Sun Kyung Lee ),차지영 ( Ji Young Cha ),조태일 ( Tae Il Cho ),김광준 ( Gwang Jun Kim ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.12

연구 목적: 질식분만을 예정하고 있는 임신 38주의 저위험 산모에서 경질식 초음파검사로 자궁경부의 변화를 관찰함으로 7일 이내에 자연적인 진통 개시에 의하여 실제 분만이 될 가능성을 예측해보고자 하였다. 대상 및 방법: 2005년 10월부터 2007년 5월까지 정기적인 산전관리를 받고 질식 분만을 예정하는 임신 37+0주에서 37+6주 사이의 저위험 단태임신 산모 110명을 대상으로 전향적연구를 시작하였다. 대상 산모 중에서 자연 진통이 시작되기 전에 제왕절개수술이나 유도분만으로 분만을 하게 된 산모가 10명, 추적관찰이 안 된 산모가 5명으로 최종 분석 대상 산모는 95명 (초산모 58명, 경산모 37명)이었다. 경질식 초음파를 이용하여 자궁경부의 길이, 자궁 경부샘의 두께, 경부의 깔대기 변형과 경부샘 형성의 4가지 변화양상을 관찰, 측정하였다. 검사일로부터 실제 분만일까지 기간을 기록하고 7일 이내 분만된 산모들과 7일 이후에 분만된 산모들을 나눈 뒤 각 자궁경부의 변화에 대해서 7일 이내 분만예측가능성을 알아보았다. 통계분석은 student-t 검사와 chi-square 검사를 시행하였고, 7일 이내 자연분만 발생을 예측하기위한 자궁경부 길이와 경부샘 두께의 기준을 찾기 위해 ROC 곡선을 그리고 교차비와 95% 신뢰구간을 구하였다. 자궁경부의 깔대기 변형과 경관형성에 대해 예민도, 특이도, 양성예측도, 음성 예측도를 구하고 교차비와 95% 신뢰구간을 정하였다. 통계적 유의성 기준은 p value 0.05로 하였다. 결과: 임신 38주 산모의 자궁경부길이는 평균 25.8 (±10.0) mm였고, 자궁 경부샘의 두께는 평균 4.3 (±1.2) mm였다. 자궁경부의 깔대기 변형은 13예 (13.7%), 경관형성은 6예 (6.3%)에서 관찰되었다. 네 가지 자궁경부변화 모두 7일 이내 분만을 예측하는 데 유용한 것으로 나타났으며 그 중 자궁경부길이가 가장 예측도가 높았다. 자궁경부길이가 2 mm 이하일 때 7일 이내에 분만할 가능성은 78.6%였고 (p<0.001), 경부샘 두께가 4 mm 이하 일 때 7일 이내 분만할 가능성은 57.1%였다 (p<0.01). 7일 이내 분만가능성에 대한 자궁경부의 깔대기 변형과 경관형성의 예민도는 각각 54.5% (p<0.001)와 36.4% (p<0.001)였다. 결론: 질식분만을 예상하는 단태의 저위험 산모에서 임신 38주에 시행한 질 초음파 검사로서 7일 이내 분만가능성을 통계적으로 유의하게 예측할 수 있었으며 네 가지 자궁경부 변화 중에서 자궁경부길이가 가장 예민한 예측인자였다. Objective: The aim of this study is to predict spontaneous labor onset delivery within 7 days in low risk pregnant women at 38 weeks` of gestation by ultrasonographic examination of cervical changes. Material & Methods: This prospective study included 110 singleton low risk pregnancies between 37+0 and 37+6 weeks of gestation. Fifteen cases were lost during follow-up and finally 95 pregnant women (58 nulliparous, 37 multiparous) were analysed. The study period was from Oct/2005 to May/2007. Four cervical changes (length, gland thickness, funneling and canal formation) were evaluated. Main outcome was remaining day to delivery after the examination. Remaining days to actual delivery with spontaneous labor onset were recorded and the pregnancies were divided into two groups according to remaining days (within 7 days, over 7 days) to compare predicting power of delivery within 7 days. ROC curves were drawn to find out cut-off values of cervical length and gland thickness. Sensitivity, specificity, positive predictive value and negative predictive value were extracted from four cervical changes. Resullts: Mean cervical length of pregnant women at 38 weeks` of gestation was 25.8 (±10.0) mm and mean cervical gland thickness was 4.3 (±1.2) mm. Funnelings of uterine cervix were detected in 13 cases (13.7%), canal formations in 6 cases (6.3%). All four cervical changes were statistically valuable to predict delivery within 7 days and the cervical length showed highest sensitivity. When the cervical length was measured under 20 mm, the possibility of delivery within 7 days was 78.6% (p<0.001). The cervical gland thickness less than 4 mm could predict the delivery within 7 days with sensitivity of 57.1% (p<0.01). Sensitivities of funneling and canal formation for delivery within 7 days were 54.5%, 36.4% each. Conclusion: Ultrasonographic examination of the cervical changes in low risk singleton pregnancy at 38 weeks` of gestation are valuable for predicting spontaneous labor onset delivery within 7 days. Among four cervical changes, cervical length is most sensitive ultrasonographic marker.

조산 예측을 위한 자궁경부 길이의 측정 임상적 적용 및 치료방법

박인양 ( In Yang Park ),신종철 ( Jong Chul Shin ) 대한주산의학회 2009 Perinatology Vol.20 No.3

Short cervical length measured by transvaginal sonography is the one of the best predictor of preterm birth. A cervical length of less than 25 mm between 16 and 24 weeks is known as the reliable threshold for an increase risk of preterm birth in all populations including singleton and multiple gestations, women with or without risk factors for preterm birth, asymptomatic women, as well as those with preterm labor or preterm premature rupture of membranes. Furthermore, measurement of cervical length is a readily learned skill for obstetrical sonographers and transvaginal ultrasonography is acceptable to pregnant women and does not cause discomfort in the vast majority. However, the measurement of cervical length is not yet recommended as routine screening method, especially for those who are at low risk for preterm birth, because there are insufficient treatment methods to prevent preterm birth once short cervix is diagnosed. Recently, not a few researches on short cervix have been focused on the development of treatment strategy. In this article, we will review relevant studies and recent advances in the use of cervical length in the prediction of preterm birth and clinical application including the use of cervical cerclage.

초음파상 자궁경부가 짧은 무증상 임신부에서 조산예방을 위한 자궁경부 원형결찰의 효용성

김민형 ( Min Hyoung Kim ),정진훈 ( Jin Hoon Chung ),최준식 ( June Seek Choi ),안현경 ( Hyun Kyung Ahn ),한정열 ( Jeong Yeol Han ),류현미 ( Hyun Mee Ryu ),김문영 ( Moon Young Kim ),양재혁 ( Jae Hyug Yang ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.11

목적: 임신 중기 초음파상 자궁경부 길이는 짧지만 조기진통의 증상이 없는 임신부에서 시행한 자궁경부 원형결찰이 조산 예방에 대한 효과가 있는지 알아보고자 하였다. 방법: 1996년 1월부터 2005년 12월까지 제일병원에서 산전 진찰을 받은 단태아 임신부들의 의무 기록을 조사하여 임신 중기 초음파에서 자궁경부 길이가 25 mm 이하로 기록된 산모를 대상으로 하였다. 초음파 당시 조기 진통의 증상이 있어 입원한 산모는 제외하였다. 조기진통의 증상이 없이 초음파상 자궁경부 길이 단축이 진단된 후 1주일 이내에 바로 자궁경부 원형결찰을 시행받은 산모를 원형결찰군에 포함시켰으며, 수술을 시행하지 않고 관찰한 경우를 기대요법군에 포함시켰다. 연구의 1차 결과로는 34주 미만의 조산의 빈도를 비교하였으며, 2차 결과로는 25 mm 이하의 짧은 자궁경부 길이를 보이는 임신부에서 조산과 가장 연관있는 요인을 분석하였다. 결과: 총 111명의 임신부가 연구대상에 포함되었으며, 평균 임신 주수는 21.6주였다. 자궁경부 원형결찰을 받은 군은 26명, 기대요법군은 85명이었다. 두 군 사이의 34주 이전에 조산한 산모의 빈도 [10예 (38.5%) vs 17예 (20.0%), P=0.069]는 차이는 없었다. 자궁경부 길이가 25 mm 이하인 경우, 조산과 연관성이 있는 요인으로는 단변량 분석에서는 15 mm 이하의 매우 짧은 경부길이와 깔때기화가 연관 있는 요인이었으나, 다변량 분석에서는 이 중 15 mm 이하의 경부 길이만이 수정 승산비가 3.67 (95% CI 1.2~10.56)로 34주 이전의 조산과 가장 연관성이 있었다. 결론: 임신 중기 초음파상 자궁경부 길이가 25 mm 이하로 짧은 임신부에서 바로 시행하는 자궁경부 원형결찰은 조산에 대한 예방효과가 기대요법과 차이가 없으며, 15 mm 이하의 자궁경부 길이를 보인 임신부는 조산에 대한 집중 관리가 필요하다. Objective: To investigate the clinical efficiency of the cervical cerclage for preventing preterm birth in asymptomatic women who showed a shortened cervix at the second trimester ultrasound Methods: From January 1996 to December 2005, we retrospectively reviewed the medical records of pregnant women who received routine second trimester ultrasound (16~24 gestational weeks) without abdominal pain or bleeding at Cheil general hospital. Women with a short cervical length ≤25 mm were classified into cerclage and expectant group. Women who received cervical cerclage within 1 week after detection of cervical shortening without any change of cervical length and shape were included in cerclage group. Primary outcome was the frequency of delivery before 34 weeks` gestation. Secondary outcome was the most important risk factor for preterm delivery in pregnant women with short cervix. Chi-square test, t-test, and multiple logistic regression analysis were used for statistical analysis. P<0.05 was considered statistically significant. Results: The mean gestational age at ultrasound was 21.6 weeks` gestation. A total of 111 women had short cervix, including 26 that were treated by cerclage and 85 managed expectantly. The proportion of preterm delivery before 34 weeks` gestation was higher in the cerclage group [38% (10 of 26)] than that of the expectant group [20% (17 of 85)], but there was no significant difference (P=0.069). In the univariate analysis, funneling (38% vs 16%, P=0.012) and cervical length ≤15 mm (47% vs 15%, P=0.069) were associated with preterm delivery before 34 weeks` gestation. In the multiple logistic regression analysis, a cervical length ≤15 mm had an adjusted odd ratio of 3.7 (95% CI 1.3~10.6) for preterm delivery before 34 weeks`s gestation. Conclusions: These data suggest that cerclage in asymptomatic woman with a short cervix in the second trimester ultrasound does not prevent preterm delivery before 34 weeks of gestation. Woman with extremely shortened cervical length ≤15 mm needs intensive management for prevention of preterm delivery.

조기진통 임신부에서 7일 이내의 조기분만의 예측에 있어 질식 초음파를 통한 자궁경부길이 측정의 유용성

정희라 ( Hee Ra Jung ),이경 ( Kyung Lee ),김명환 ( Myoung Hwan Kim ),고지경 ( Ji Kyung Ko ),이철민 ( Chul Min Lee ),조용균 ( Yong Kyoon Cho ),최훈 ( Hoon Choi ),김복린 ( Bok Rin Kim ) 대한주산의학회 2009 Perinatology Vol.20 No.3

목적: 조기진통이 있는 임신부에서 7일 이내의 조기분만의 예측에 있어 질식 초음파를 이용한 자궁경부 길이의 유용성을 알아보고자 하였다. 방법: 2001년 1월부터 2006년 12월까지, 임신 24주에서부터 33주 6일까지 조기진통으로 인제대학교상계백병원 산부인과에 입원한 환자들을 대상으로 후향적으로 분석하였다. 입원 당시 질식 초음파를 이용하여 자궁경부 길이를 측정하였으며 연구의 일차적 성과의 판단기준(primary outcome measure)은 7일 이내의 분만으로 정하였다. 결과: 전체 연구 대상자 140명 중 7일 이내의 분만은 11/140 (7.9%)에서 발생하였다. ROC curve 분석 결과 7일 이내의 조기 분만을 예측하는 가장 적절한 자궁경부 길이의 기준치는 25 mm였으며 이는 민감도 94%, 특이도 75%를 나타내었다. 자궁경부 길이가 25 mm 이하인 경우 전체 46명 중 10명(21.7%), 자궁경부 길이가 25 mm 초과인 경우 전체 94명중 1명(1.1%)에서 7일 이내에 조기분만이 발생하였다. 또한 자궁경부 길이 25 mm를 기준으로 입원 후 분만까지 걸린 시간을 생존 곡선으로 분석하였을 때 자궁경부 길이가 25 mm 이하인 경우 입원 후 분만까지 시간이 의미 있게 짧게 걸리는 것으로 나타났다. 다변량회귀 분석에서는 자궁경부 길이(≤25 mm) (OR: 24.64, 95% Cl: 2.97~204.20, P=0.003)만이 조기진통 산모에서 7일 이내의 분만을 예측하는데 통계학적으로 유의한 의미를 나타내었다. 결론: 조기진통이 있는 임신부에서 질식 초음파를 이용한 자궁경부 길이의 측정이 7일 이내의 조기분만을 예측하는데 있어 유용하다. Purpose: To investigate the usefulness of transvaginal ultrasonographic measurement of cervical length in patients with preterm labor for prediction of preterm delivery within 7 days. Methods: Cervical length was measured by transvaginal ultrasound in 140 women with singleton pregnancies presenting with preterm labor and intact membranes from 24(+0) to 33(+6) weeks of gestation. Other potential predictive factors, such as Bishop score, previous history of preterm delivery, and parity were assessed. Results: The mean gestational age at presentation was 30.5±14.7 (range, 24.0 to 33.6) weeks and the mean cervical length was 29.0±0.9 (range, 31.0 to 52.1) mm. Delivery within 7 days occurred in 7.9% (11/140). Receiver-operating characteristics (ROC) curves established a cervical length of 25 mm as the most relevant cut off level for prediction of delivery within 7 days. Interval between admission and delivery was significantly short when ultrasonographic cervical length was less than or equal to 25 mm. Logistic regression analysis demonstrated that the significant independent risk factors were cervical length ≤25 mm (OR: 24.64, 95% C1: 2.97~204.20, P=0.003). Conclusion: Ultrasonographic cervical length measurement is a useful tool for prediction of progression to preterm delivery within 7 days with patients with preterm labor.