孕12-18周经阴道超声测量宫颈长度在宫颈环扎术前的临床参考价值分析

Clinical Reference Value of Cervical Length Measured by Transvaginal Ultrasound at 12-18 Weeks of Gestation before Cervical Cerclage

目的:探讨孕12-18周经阴道超声测量宫颈长度在宫颈环扎术前的临床参考价值。方法:选取2016年1月-2018年10月在我院就诊的孕12-18周单活胎初孕妇,采用阴道超声检测并筛选出宫颈长度<25mm或伴有宫颈内口扩张的有流产或早产可能的100例孕妇作为研究对象,选择同意行宫颈环扎术的50例孕妇为观察组,不同意行宫颈环扎术的50例孕妇为对照组,观察组予以行宫颈环扎术,对照组不作宫颈环扎术干预,两组均随访至分娩,比较两组的孕周、宫颈长度及宫颈内口宽度以及妊娠结局情况。结果:两组的宫颈长度及宫颈内口宽度比较差异无显著性(P>0.05),孕周显著长于对照组(P<0.05);观察组的早产及流产发生率为38.00%,显著低于对照组的60.00%(P<0.05)。结论:妊娠期在孕12-18周期间经阴道超声测量宫颈长度及宫颈内口宽度对于流产或早产具有一定预测价值,与宫颈环扎术相结合运用能够有效降低流产或早产的发生,改善不良妊娠结局。

Objective: To explore the clinical reference value of cervical length measured by transvaginal ultrasound at 12-18 weeks before cervix cerclage. Methods: The clinical data of primigravida with live singleton pregnant for 12-18 weeks received in the Hospital between January 2016 and October 2018 were selected. 100 women were selected as the subjects by means of transvaginal ultrasound who had the possibility of miscarriage or premature birth due to cervical length <25 mm or cervical internal dilatation. The 50 pregnant women who agreed to undergo cervical cerclage were selected as the observation group, and the other 50 pregnant women who did not agree as the control group. Cervical cerclage was performed on women in the observation group, and no cervical cerclage intervention given to the control group. The two groups were followed up until delivery, and the gestational age, cervical length, cervix width and pregnancy outcome were compared between the two groups. Results: There was no significant difference in cervical length and cervix width between the two groups (P>0.05), and the gestational age in the observation group was significantly longer than the control group (P<0.05). The incidence of preterm birth and miscarriage in the observation group was 38.00%, significantly lower than that in the control group, which was 60.00%(P<0.05). Conclusion: Transvaginal ultrasound measurement of cervical length and cervical sinus width during pregnancy for 12 and 18 weeks is with certain predictive value for miscarriage or premature delivery. Combined with cervical cerclage, it can help reduce the occurrence of miscarriage or premature delivery and improve the adverse pregnancy outcome.