الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Preterm labour is defined as the onset of labour at a gestational age between 20 and 37 completed weeks. There are several causes of preterm delivery, but the commonest are infection, followed by iatrogenic causes and idiopathic. Cervical ultrasound is superior to risk scoring systems, digital examination of the cervix and serological markers as a predictor of preterm labour in asymptomatic risky patients and also in symptomatic ones. Cervical length (CL) of <30 mm at midgestation will identify most of women destined to deliver preterm.
Cervical Glandular Area (CGA) represents the endocervical mucosal epithelial glands and appears as hypoechoic zone parallel to the cervical canal. The importance of absence of the cervical glandular area in mid-trimester trans-vaginal sonogram may exceed that of the short cervix and the presence of cervical funneling.
The only evidenced management of PTL is maternal steroid therapy. There were controversies about the use of tocolysis and also there is no ideal tocolytic agent. During the last decade there was a preferential use of calcium channel blockers (specifically nifidipine) over other tocolytic agents. We suggest that nimodipine may work better than its oral counterparent “nifidipine” and may has a neuroprotection action to the preterm babies.
Pentoxifylline is a non-selective inhibitor of phosphodiesterase and causes an increase in intracellular concentration of c-AMP. It can decrease uterine activity by increasing the intracellular concentration of c-AMP and thereby lowering the Ca++ concentration. We suggest that pentoxifylline use as a supplement to tocolytic therapy may beneficially improve neonatal outcome in preterm delivery.
Our study is a randomized controlled trial that was designed to assess the role of nimodipine with and without pentoxifylline on cervical length and cervical glandular area in management of cases of threatening preterm birth. It was conducted on two hundred pregnant women admitted to the emergency department of El-Shatby Maternity University Hospital complaining of preterm labour pains. They were divided into four groups, each had fifty patients. The first group received nimodipine and dexamethasone. The second group received pentoxifilline and dexamethasone. The third group received nimodipine, pentoxifilline and dexamethasone. The fourth group received dexamethasone only.