不同孕期检测宫颈长度预测早产的临床价值

The Clinical Value of Cervical Length Measurement for Prediction of Premature Birth in Different Gestation

目的：探讨不同孕期测量宫颈长度（ CL）预测早产的价值。方法：对定期产前检查的单胎初产孕妇368例，分别于孕24～28周、30～34周经阴道超声测量宫颈长度，观察妊娠不同阶段宫颈长度变化及对早产的预测价值。结果：①宫颈长度变化。孕24～28周测量368例，CL平均37.87±3.10 mm；30～34周测量363例，CL平均为34.23±4.41 mm。二者比较有极显著性差异（ P＜0.01）。②不同孕期宫颈长度与早产的关系。孕24～28周368例中，足月分娩340例（占92.39％），早产28例（占7.61％）。与CL≥30 mm的孕妇比较，CL 25～29 mm、＜25 mm的孕妇早产发生的风险分别为4.35倍、7.97倍，且具有显著性差异（ P＜0.05）。孕30～34周363例中，足月分娩338例（占93.12％），早产25例（占6.88％）。与CL≥30 mm的孕妇比较，CL 25～29 mm、＜25 mm的孕妇早产发生的风险分别为8.4倍、16.04倍，且具有显著性差异（ P＜0.05）。③不同孕期宫颈长度预测早产的价值。以宫颈长度＜25 mm为早产预测值，孕24～28周、30～34周在敏感性、特异性、阳性预测值、阴性预测值之间无显著性差异（ P＞0.05）。结论：孕晚期与孕中期比较，宫颈显著缩短；宫颈长度与早产的发生存在关联，且长度越短风险越大；但是不同孕周宫颈长度在预测早产结果准确性上没有什么区别。

Objective：To investigate the value of cervical length （ CL ） measurement for prediction of premature birth in different gestation .Methods：Recorded the cervical length of 368 cases of primiparas with single embryo during regular antenatal examination with transvaginal measurement , respectively in 24 -28 weeks of pregnancy and 30-34 weeks of pregnancy , and observed the predictive value of preterm birth with cervical length change in different stages of pregnancy .Results：①Cervical length changes：in 368 cases of 24-28 weeks pregnancy the CL was 37.87 ±3.10 mm, in 363 cases of 30-34 weeks of pregnancy the CL was 34.23 ±4.41 mm, and the difference was statistically significant （ P 〈0.01 ） .②The relationship between cervical length and preterm birth in different gestation：368 cases of 24-28 weeks pregnancy , in which there were 340 cases of full -term birth （ 92.39%） , 28 cases of premature birth （ 7.61%） .Compared with in pregnant women with CL≥30 mm, the risk of preterm birth occurred 4.35, 7.97 times respectively in pregnant women with a CL 25-29 mm or 〈25 mm, the difference was statistically significant （ P〈0.05 ） . 363 cases of 30 -34 weeks pregnancy , in which there were 338 cases of full -term birth （ 93.12%） , 25 cases of premature birth （ 6.88%） .Compared with that in pregnant women with CL≥30 mm, the risk of preterm birth occurred 8.4, 16.04 times respectively in pregnant women with a CL 25-29 mm or 〈25 mm, the difference was statistically significant （ P 〈0.05 ） .③The value of cervical length measurement for prediction of premature birth in different gestation：Adopted the predictive value of cervical length 〈25 mm for premature birth, the differences insensitivity, specificity, positive predictive value, negative predictive valuewere not statistical significance （P 〉0.05） at 24 -28 weeks and 30 -34 weeks pregnancy.Conclusion：Compared with in mid -trimester,the cervical length is significantly shortened in late trimester ; the cervicallength is associated with the occurrence of premature birth , the shorter of cervical length the greater of risk;but there is no difference in different cervical lengths with in different gestation for prediction of prematurebirth.