宫颈超声检查结合临床高危因素预测早产的价值

Value of cervix ultrasonography combined with clinical risk factors in premature labor prediction

目的研究早产的危险因素以及对妊娠结局的影响,评估超声测量宫颈长度对预测早产的价值。方法超声测量131例有先兆早产症状的孕妇的宫颈,追踪孕妇的妊娠结局,并对照133例足月分娩孕妇,分析早产高危因素及母婴结局。结果早产组中,胎膜早破占42.75%,阴道炎症占32.06%,产前出血占20.61%,均较对照组高,差异有统计学意义(P<0.05)。早产儿的窒息率为16.79%,死亡率为6.87%,均较对照组高(P<0.05)。131例先兆早产孕妇中,68例宫颈大于30mm,3d、7d、14d内分娩率分别为15.64%、27.6%、56.76%;63例宫颈小于30mm的孕妇3d、7d、14d内分娩率分别为52.38%、30.15%、17.47%。同样宫颈条件下,因高危因素不同则早产结局不同。结论先兆早产孕妇宫颈长度超声筛查对早产的发生有一定的预测价值,结合高危因素对预测其短期内发生早产的临床价值更大。

Objective To explore the risk factors of premature labor and its i^ffluenee on pregnancy outcome, and to assess the predictive value of cervical length measurement for premature labor by uhrasonography. Methods Cervical length was measured by ultrasonography in 131 women with threatened premature labor, their pregnancy outcomes were followed up, the results were compared with those of 133 pregnant women in control group. Results In premature labor group, there were 42.75% patients with premature rupture of membranes, 32.06% patients with vaginal inflammation, 20.61% patients with prenatal haemorrhage. Compared with control group, there was significant difference between two groups （ P 〈 0.05 ）. The asphyxia and mortality rate in premature children were 16.79% and 6.87% ,respectively,which were higher than those in control group （ P 〈 0.05 ）. In 131 pregnant women with threatened premature delivery, there were 68 patients with cervical length 〉 30 ram, and the deliver rate within 3 d,7 d and 14 d was 15.64% ,27.60% and 56.76% ,respectively. While there were 63 patients with cervical length 〈30 ram, and the deliver rate within 3 d,7 d and 14 d was 52.36% ,30.15% and 17.47% ,respectively. Under the same cervical condition, different risk factors have different results of premature labor. Conclusion Cervical length measured by uhrasonography in women with threatened premature labor has high prediction value, and combined with high risk factors, it has higher clinical application value in predicting premature labor.