经阴道三维超声评估妊娠期宫颈预测早产的临床研究

Clinical research on transvaginal three-dimensional ultrasound for evaluation of cervix during pregnancy and prediction for preterm delivery

目的评价三维超声检查宫颈的临床应用价值。方法回顾性分析2011年6月～2013年5月来本院进行建卡产前检查的孕妇资料,选择妊娠28～37周早产的28例孕妇为研究组,28例孕周≥37周足月分娩孕妇为对照组。对两组孕妇在第22、27、31、35周采用经阴道三维超声检测宫颈结构,研究各项超声监测指标与先兆早产预后的相关性。结果研究组和对照组的宫颈长度随着妊娠周数的增加而减小;宫颈指数随着妊娠周数的增加而增加;研究组宫颈长度均值<3 cm,对照组宫颈长度均值>3 cm;研究组的宫颈指数均值>0.5,对照组宫颈指数均值<0.5,两组宫颈长度以及宫颈指数比较,差异有统计学意义(P<0.01)。结果显示宫颈越短,宫颈指数越大越的孕妇容易发生早产。结论经阴道三维超声评估妊娠期孕妇宫颈结构,是预测早产发生的一个有效手段。

Objective To evaluate the clinical value of three-dimensional uhrasound for inspecting cervix. Methods The clinical materials of pregnant women received prenatal checkup in our hospital from June 2011 to May 2013 were analyzed retrospectively. The research group included 28 pregnant women with premature birth at 28-37 weeks after conception; and control group included 28 pregnant women term birth more than 37 weeks after conception. Transvagi- nal three-dimensional ultrasound was used to detect cervical structure and other technical index for two groups of pregnant women at 22, 27, 31 and 35 weeks after conception. The correlation between all ultrasound monitoring indi- cators and prognosis for threatened premature labor was studied. Results Cervical length of research group and control group reduced with the increase of pregnancy time; cervical index increased with the increase of pregnancy time. The mean cervical length of research group was less than 3 cm, and that of control group was more than 3 cm; cervical in- dex of research group was more than 0.5, and that of control group was less than 0.5. The cervical length and cervical index between two groups had significant difference （P〈0.01）. The data showed that if cervix uteri was shorter and cer- vical index was larger, it was easier to cause preterm birth. Conclusion Transvaginal three-dimensional ultrasound used to evaluate the cervical structure of pregnant women is an effective way of predicting preterm birth.