Maternal Serum Level of ACTH as a Predictive Marker of Preterm Labor in Patients With Threatened Preterm Labor
Condition: Threatened Preterm Labor
MeSH terms: Premature Birth; Obstetric Labor, Premature
Study type: Observational [Patient Registry]

Summary: 
      The aim of this study is use of ACTH as a predictive marker in patients of threatened preterm
      labor .
    

Detailed description: 
      This is a cross sectional study that will include 261 pregnant women aged between 17 and 35
      years with singleton pregnancies between 28 and 36 completed weeks of gestation that had been
      diagnosed with threatened preterm labor and consented to participate in this study. This
      study will be conducted at Ain Shams University Maternity Hospital after approval of the
      research and ethics committee.

      the investigators include all patients which have these following criteria (Singleton
      pregnancy, Age between 17 - 35 years, Gestational age between 28 and 36 weeks and Diagnosis
      of threatened preterm labor is based on the American College of Obstetricians and
      Gynaecologists Guidelines (ACOG, 2003): Presence of uterine contractions (at least 4 in 20
      minutes or 8 in 60 minutes), Cervical dilation > 1 and < 4 cm, and/or Cervical effacement ≥
      80%.

      the investigators exclude any patient which has any of the following criteria (Preterm
      rupture of membranes, Any uterine anomalies or cervical incompetence, Chronic illness such as
      chronic hypertension or kidney disease, Diabetes mellitus, Abruptio placenta, Preeclampsia
      and HELLP syndrome, Fetal anomalies, IUGR, Smoking or Clinical signs of intrauterine
      infection).

      blood sample was collected from each patient for measurement of ACTH level. According to
      local protocol in Ain Shams University Maternity Hospital all women will receive a fixed
      regimen of tocolysis in the form of nifedipine (Epilat) 10 mg orally every 15 minutes for the
      first hour or until cessation of uterine contractions. Then, 60 - 160 mg/day (1-2 tablets 3
      times daily) of slowly releasing nifedipine (epilat retard 20 mg tablet) may be given
      depending on uterine activity. The patients will also receive 6 mg dexamethasone every 12
      hours for 4 doses. All women will be followed up till delivery.

      After delivery, the investigators divide the patients into 2 groups (full term delivery &
      preterm delivery) and we compare between these 2 groups by level of hormone.
    

Intervention name(s): collection of blood sample and tocolysis adminstration
Intervention type(s): Other
Intervention description(s): investigators will abtain a blood sample from all patient to measure the serum level of ACTH.
all patients with threatened preterm labor will receive a fixed regimen of tocolysis in the form of nifedipine (Epilate) 10 mg orally every 15 minutes for the first hour or until cessation of uterine contractions. Then, 60 - 160 mg/day (1-2 tablets 3 times daily) of slowly releasing nifedipine (epilat retard 20 mg tablet) may be given depending on uterine activity. The patients will also receive 6 mg dexamethasone every 12 hours for 4 doses. All women will be followed up till delivery.
After delivery, investigators devide the pateints into 2 groups (full term delivery & preterm delivery) and investigators compare between these 2 groups by level of hormone.
Observational model: Case-Only
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        pregnant women aged between 17 and 35 years with singleton pregnancies between 28 and 36
        completed weeks of gestation that had been diagnosed with threatened preterm labor
      
Biospecimen description: 
      serum
    
Keywords: threatened preterm labor; ACTH; PTL