阴道超声监测先兆早产孕妇的宫颈预测其妊娠结局

The Value of Transvaginal Ultrasonographic Examination of the Uterine Cervix in Predicting Preterm Delivery

目的 评价阴道超声监测宫颈对早产的预测价值。 方法 采用阴道超声对 5 2例先兆早产患者进行宫颈监测以预测保胎治疗后的妊娠结局。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 5 2例先兆早产患者中 14例发生早产 ,早产的发生率为 2 6 .92 % (14/ 5 2 )。各项超声监测指标均与先兆早产预后显著相关 (P均 <0 .0 0 1) ,而宫颈长度是预测早产的最佳超声指标。制作 ROC曲线 ,结果显示宫颈长度 17mm为最佳临界值 ,预测早产的敏感性为 78.5 7% ,特异性为 86 .84% ,准确性为 84.6 2 %。 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 pretem delivery. Methods Transvaginal ultrasonography (TVS) was performed in 52 patients admitted with threatened preterm labor and with intact membranes. Cervical parameters of the ultrasonography were evaluated including endocervical length, the presence of funneling, funnel length, funnel width and cervical indexs[(Funnel length+1)/Endocervical length]. Results The prevalence of preterm delivery was 26.92%(14/52) in 52 patients with threatened preterm labor despite routine tocolytic therapy. A significant relationship was indicated by logistic regression analysis between the occurrence of preterm delivery and ultrasonographic cervical parameters( P <0.001 respectively). But of all ultrasonographic parameters the cervical length was the best predictor of preterm delivery. Receiver operating characteristic curve analysis showed that a cervical length of 17 mm was the best cut off point to predict the preterm delivery occurrence, the sensitivity and specificity were 78.57% and 86.84% respectively. Conclusions It is suggested that the transvaginal uitrasonographic examination of the uterine cervix is an objective and accurate method for the prediction of the outcome of the patients with threatened preterm labor and intact membranes.