阴道超声监测先兆早产孕妇的宫颈对早产预测的价值

The value of transvaginal ultrasonographic examination of the uterine cervix in predicting preterm delivery for pregnant women with threatened preterm labor

目的:评价阴道超声监测宫颈对早产的预测价值。方法:采用阴道超声监测189例先兆早产孕妇的宫颈,并追踪妊娠结局,评价对早产的预测价值。超声监测指标为宫颈长度、漏斗形成、漏斗长度、漏斗宽度及宫颈指数[(漏斗长度+1)/宫颈长度]。结果:189例先兆早产孕妇中早产率为34.4%(65/189)。各项超声监测指标均与先兆早产预后有关,而宫颈长度是预测早产的最佳超声指标。ROC曲线结果显示宫颈长度25 mm是预测早产的最佳工作点。宫颈长度≤25 mm时预测早产的敏感度为67.7%,特异度为75.0%,阳性预测值为58.7%,阴性预测值为81.6%。结论:应用阴道超声监测宫颈,可客观、准确地预测早产。

Objective： To evaluate the value of transvaginal ultrasonographic examination of the uterine cervix in predicting preterm delivery for pregnant women with threatened preterm labor.Methods： Transvaginal ultrasonographic（TVS） was performed in 189 women with threatened preterm labor.Cervical parameters of the ultrasonography were evaluated including cervical length,the presence of funneling,funnel length,funnel width and cervical indexs [（Funnel length ＋1）/Cervical length].Results： The prevalence of preterm delivery was 34.4%（65/189） in 189 women with threatened preterm labor.A significant association was indicated by logistic regression analysis between the occurrence of preterm delivery and ultrasonographic cervical parameters.But of all ultrasonographic parameters the cervical length were the best predictor of preterm delivery.Receiver operating characteristic curve（ROC） analyses showed that a cervical length of 25 mm was the optimal cut-off to predict the perterm delivery occurrence,the sensitivity,specificity,positive predictive value（PPV） and negative predictive value（NPV） were 67.7%,75.0%,58.7%,81.6%respectively.Conclusion： It is suggested that the transvaginal ultrasonographic measurement of the uterine cervix is an objective and accurate method in predicting preterm delivery for pregnant women with threatened preterm labor.