Creasy et al developed the Risk of Preterm Delivery (PTD) system for identifying pregnant women at risk for preterm delivery. This can help identify patients who may require more aggressive therapy or monitoring. The authors are from the University of California in San Francisco and the National Women's Hospital in Auckland, New Zealand.
Preterm labor: admission to the hospital in apparent labor before 37 completed weeks of gestation.
Parameters:
(1) age of the patient
(2) height
(3) weight
(4) socioeconomic status
(5) single parent
(6) number of children at home
(7) number of abortions
(8) period since last pregnancy
(9) history of pyelonephritis
(10) uterine anomaly
(11) history of DES exposure
(12) history of premature delivery
(13) history of second trimester abortion
(14) work location
(15) intensity of work
(16) smoking
(17) travel
(18) unusual fatigue during current pregnancy
(19) weight gain by 32 weeks during current pregnancy
(20) albuminuria during current pregnancy
(21) hypertension during current pregnancy
(22) bacteriuria during current pregnancy
(23) breech at 32 weeks during current pregnancy
(24) weight loss during current pregnancy
(25) head engaged during current pregnancy
(26) febrile illness during current pregnancy
(27) metrorrhagia after 12 weeks gestation during the current pregnancy
(28) cervical effacement during current pregnancy
(29) cervical dilatation during current pregnancy
(30) uterine irritability (contractions) during current pregnancy
(31) placenta praevia during current pregnancy
(32) hydramnios (excess amniotic fluid) during current pregnancy
(33) twins during current pregnancy
(34) abdominal surgery during current pregnancy
|
Parameter |
Finding |
Points |
|---|---|---|
|
age of the patient |
< 18 years of age |
4 |
|
|
18 or 19 years of age |
2 |
|
|
20 to 40 years |
0 |
|
|
> 40 years of age |
2 |
|
height |
< 150 cm |
3 |
|
|
>= 150 cm |
0 |
|
weight |
< 45 kilograms |
3 |
|
|
>= 45 kilograms |
0 |
|
socioeconomic status |
very low |
3 |
|
|
low |
1 |
|
|
middle to upper class |
0 |
|
single parent |
yes |
2 |
|
|
no |
0 |
|
number of children at home |
2 (assume >= 2) |
1 |
|
|
0 or 1 |
0 |
|
number of abortions |
0 |
0 |
|
|
1 |
1 |
|
|
2 |
2 |
|
|
3 (assume >= 3) |
3 |
|
period since last pregnancy |
< 1 year |
1 |
|
|
>= 1 year |
0 |
|
history of pyelonephritis |
no |
0 |
|
|
yes |
4 |
|
uterine anomaly |
absent |
0 |
|
|
present |
5 |
|
history of DES exposure |
no |
0 |
|
|
yes |
5 |
|
history of premature delivery |
no |
0 |
|
|
yes |
10 |
|
history of second trimester abortion |
no |
0 |
|
|
single |
5 |
|
|
repeated |
10 |
|
work location |
at home |
0 |
|
|
outside home |
1 |
|
intensity of work |
light to moderate |
0 |
|
|
heavy |
3 |
|
smoking |
> 10 cigarettes per day |
2 |
|
|
<= 10 cigarettes per day |
0 |
|
travel |
long and tiring |
3 |
|
|
not long and tiring |
0 |
|
unusual fatigue during current pregnancy |
present |
1 |
|
|
absent |
0 |
|
weight gain by 32 weeks during current pregnancy |
< 13 kg |
2 |
|
|
>= 13 kg |
0 |
|
albuminuria during current pregnancy |
absent |
0 |
|
|
present |
2 |
|
hypertension during current pregnancy |
absent |
0 |
|
|
present |
2 |
|
bacteriuria during current pregnancy |
absent |
0 |
|
|
present |
2 |
|
breech at 32 weeks |
absent |
0 |
|
|
present |
3 |
|
weight loss |
< 2 kilograms |
0 |
|
|
>= 2 kilograms |
3 |
|
head engaged during current pregnancy |
present |
3 |
|
|
absent |
0 |
|
febrile illness during current pregnancy |
present |
3 |
|
|
absent |
0 |
|
metrorrhagia after 12 weeks gestation |
present |
4 |
|
|
absent |
0 |
|
effacement |
present |
4 |
|
|
absent |
0 |
|
cervical dilatation |
present |
4 |
|
|
absent |
0 |
|
uterine irritability |
present |
4 |
|
|
absent |
0 |
|
placenta praevia during current pregnancy |
present |
5 |
|
|
absent |
0 |
|
hydramnios during current pregnancy |
present |
5 |
|
|
absent |
0 |
|
twins during current pregnancy |
present (probably multiple gestation) |
5 |
|
|
absent |
0 |
|
abdominal surgery during current pregnancy |
present |
10 |
|
|
absent |
0 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: > 50
• The higher the score, the higher the risk of preterm delivery
|
Total Score |
Risk of Preterm Delivery |
|---|---|
|
0 to 5 |
low risk |
|
6 to 9 |
intermediate risk |
|
>= 10 |
high risk |
Specialty: Obstetrics & Gynecology
ICD-10: ,
